Provider Demographics
NPI:1326898206
Name:ABREU, JESSICA (APN RESIDENT, PMHNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ABREU
Suffix:
Gender:F
Credentials:APN RESIDENT, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VIVIAN AVE
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1123
Mailing Address - Country:US
Mailing Address - Phone:845-664-3411
Mailing Address - Fax:
Practice Address - Street 1:7 VIVIAN AVE
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1123
Practice Address - Country:US
Practice Address - Phone:845-664-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13343100163WP0808X
NJ26NJ15063800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health