Provider Demographics
NPI:1598251415
Name:NUNEZ, JESSICA A (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 INGRASSIA RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2238
Mailing Address - Country:US
Mailing Address - Phone:845-421-5414
Mailing Address - Fax:
Practice Address - Street 1:56 WALTON TER
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1254
Practice Address - Country:US
Practice Address - Phone:845-323-5438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600239-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health