Individual
JAMIE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14 SPRUCE ST, KINGSTON, NY 12401-6612
(845) 943-0133
Mailing address
14 SPRUCE ST, KINGSTON, NY 12401-6612
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402372
NY
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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