Individual
JESSICA MARIA KIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3183
Mailing address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3183
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309407
NY
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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