MEDICARE: JESSICA STEELE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	307647	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	402860	NY

General Provider Information

NPI Number	:	1043673452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA STEELE NP

Provider Business Mailing Address
First Line	:	PO BOX 260218
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-0218
Country	:	US
Telephone Number	:	212-564-7631
Fax Number	:

Provider Business Practice Location Address
First Line	:	566 7TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-1802
Country	:	US
Telephone Number	:	212-564-7631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	08/02/2023

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