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Individual

JEAN LUTHER PAINSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1016 E 81ST ST, BROOKLYN, NY 11236-4222
(717) 716-7107
Mailing address
1016 E 81ST ST, BROOKLYN, NY 11236-4222

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401460
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03621116
NY
01
401460
NURSE PRACTITIONER LICENSE
Enumeration date
03/18/2012
Last updated
03/09/2026
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