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Individual
JESSICA DIAZ
Active
Individual
JESSICA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
657264
NY
363LA2200X
Adult Health Nurse Practitioner
311727
NY
363LF0000X
Family Nurse Practitioner
Primary
356845
NY
Other
Enumeration date
11/03/2023
Last updated
07/28/2025
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