Healthcare Provider Details

I. General information

NPI: 1184144073
Provider Name (Legal Business Name): JASMINE I. HUMPHREY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 PLEASANT ST STE 207
FALL RIVER MA
02721-3005
US

IV. Provider business mailing address

277 PLEASANT ST STE 207
FALL RIVER MA
02721-3005
US

V. Phone/Fax

Practice location:
  • Phone: 508-567-6920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2299344
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN03573
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2299344
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: