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Organization

BLUE RIVER PSYCHIATRY NP PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MINA JOHNSON (PRACTITIONER)
(914) 401-0008
Entity
Organization

Contact information

Practice address
369 WASHINGTON AVE, KINGSTON, NY 12401-3701
(914) 401-0008
(914) 401-0009
Mailing address
369 WASHINGTON AVE STE 1A, KINGSTON, NY 12401-3701
(914) 401-0008
(914) 401-0009

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
02/24/2022
Last updated
03/14/2024
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