Individual
MS. TAYLOR JEANNINE COUNTRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1 FAMILY PRACTICE DR, KINGSTON, NY 12401-6449
(845) 338-2562
Mailing address
524 QUEENS HWY, ACCORD, NY 12404-6106
(845) 702-7193
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404243
NY
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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