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Individual
JOHN N JESSUP
Active
Individual
JOHN N JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
F-332697
NY
363L00000X
Nurse Practitioner
F322697
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F332697
NY
363LF0000X
Family Nurse Practitioner
F332697
NY
Other
Enumeration date
09/23/2005
Last updated
11/09/2010
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