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

Jennifer Kanaly

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1780045724

Jennifer Kanaly is a Nurse Practitioner in Peru, New York. Qualified in 2015, 11 years ago. Practices with Citizen Advocates, Inc, a 50-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2016
Specialties on file
2

Practice location Address checks out

287 John Boswell Rd
Peru, NY 12972
Phone: (518) 420-2073
Fax: (518) 763-0895
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 40 401976 (NY)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 401976 (NY)

Record details

NPI number1780045724
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 18, 2016
Last updated in NPPESSeptember 9, 2020
Certification dateSeptember 9, 2020
Mailing address75 Beekman St, Plattsburgh, NY 12901-1438

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Citizen Advocates, Inc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare