Individual
JESSICA WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PNP
Contact information
Practice address
363 ROUTE 111 STE 103, SMITHTOWN, NY 11787-4750
(631) 488-0612
(631) 629-6762
Mailing address
363 ROUTE 111 STE 103, SMITHTOWN, NY 11787-4750
(631) 488-0612
(631) 629-6762
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
590317
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382909
NY
Other
Enumeration date
02/25/2010
Last updated
07/30/2019
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