Provider Demographics
NPI:1184436099
Name:HANNOUSHE, JESSICA (FNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:HANNOUSHE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 LITTLE BRITAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5518
Mailing Address - Country:US
Mailing Address - Phone:845-500-1985
Mailing Address - Fax:
Practice Address - Street 1:819 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5518
Practice Address - Country:US
Practice Address - Phone:845-500-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY355866363LF0000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily