Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer Anne Shattuck, NP

Individual provider Family Nurse Practitioner · NPI 1023032729

Jennifer Anne Shattuck, NP is a Nurse Practitioner in Johnson City, New York. Qualified in 2005, 21 years ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2006
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

260 Riverside Dr
Johnson City, NY 13790-2745
Phone: (607) 798-7811
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 334772 (NY)

Record details

NPI number1023032729
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 26, 2006
Last updated in NPPESMarch 19, 2021
Certification dateMarch 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Johnson City