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General NPI Number Information
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NPI Number | 1548686074
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Entity Type | Individual
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Provider Name | JESSICA NYMEYER
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Gender | Female
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 808 COLUMBUS AVE APT 15N
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City | NEW YORK
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State | NY
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Zip | 10025-5139
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Country | US
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Telephone | 206-313-8656
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Fax |
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Provider Business Mailing Address
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Address Line | 808 COLUMBUS AVE APT 15N
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City | NEW YORK
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State | NY
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Zip | 10025-5139
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Country | US
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Telephone | 206-313-8656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 627787-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 430891
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License Number State | NY
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