Individual
MS. JESSICA COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-6345
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F431082
NY
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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