Organization
WELL SPACE NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH PLLC
Active
Other names
Orange Family Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JACKSON PMHNP (OWNER)
(347) 696-1375
Entity
Organization
Contact information
Practice address
266 BROADWAY STE 401, BROOKLYN, NY 11211-6306
(347) 696-1375
(914) 222-8973
Mailing address
266 BROADWAY STE 401, BROOKLYN, NY 11211-6306
(347) 696-1375
(914) 222-8973
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
01/29/2026
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