Individual
ERTHA JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6209 16TH AVE, BROOKLYN, NY 11204-2702
(718) 234-0073
Mailing address
540 E 22ND ST APT 1B, BROOKLYN, NY 11226-7265
(718) 859-5013
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305339-1
NY
Other
Enumeration date
04/16/2010
Last updated
06/20/2013
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