JESSICA WALTHALL

NEW YORK, NY
NPI1104316454
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner Pediatrics
(Licence: NY  382872)
Additional Taxonomies163W00000X Registered Nurse
(Licence: CT  137013)
163W00000X Registered Nurse
(Licence: NY  727527)
Enumeration Date2018-05-12
Last Update Date2022-01-18
Business Address
JESSICA WALTHALL PPCNP-BC
2637 BROADWAY
NEW YORK, NY 10025-5022
Phone number: 917-921-6219
Mailing Address
JESSICA WALTHALL PPCNP-BC
2637 BROADWAY
NEW YORK, NY 10025-5022
Phone number: 917-921-6219