Individual
KJERSTEN DIANE DOSUMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(646) 317-6041
Mailing address
2098 FREDERICK DOUGLASS BLVD APT 8Q, NEW YORK, NY 10026-2794
(385) 234-1991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F309675-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F309675
NY
363LG0600X
Gerontology Nurse Practitioner
F309675
NY
363LP2300X
Primary Care Nurse Practitioner
F309675-01
NY
Other
Enumeration date
09/22/2020
Last updated
05/26/2023
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