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Colletta Latoya Jerrick, NURSEPRACTITIONER
Psychiatric/Mental Health Nurse Practitioner in Bay Shore, New York
NPI 1922720887

Colletta Latoya Jerrick is a Psychiatric/Mental Health Nurse Practitioner based in Bay Shore, NY and is specialized in Psychiatric/Mental Health. Colletta Latoya Jerrick practices in Bay Shore, NY and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Colletta Latoya Jerrick is 1922720887 and holds a License No. F403813-01 (New York).

The current practice location address for Colletta Latoya Jerrick is 1548 E Forks Rd, Bay Shore, NY and can be reached out via phone at 631-308-7658.

Location: 1548 E Forks Rd, Bay Shore, NY, 11706-3144
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Provider Profile Details
NPI Number
1922720887
Provider Name
Colletta Latoya Jerrick
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
1548 E Forks Rd, Bay Shore, NY, 11706-3144
Phone Number
631-308-7658
Fax Number
Provider Enumeration Date
09/16/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
F403813-01 01 NY NEW YORK STATE OFFICE OF THE PROFESSIONS
institution
Provider Business Practice Location Address Details
Address
1548 E Forks Rd
City
State
Zip
11706-3144
Phone Number
631-308-7658
Fax Number
person
Provider Business Mailing Address Details
Address
1548 E Forks Rd
City
State
Zip
11706-3144
Phone Number
631-308-7658
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
F403813-01 (New York)
Definition
Definition to come...
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