Provider Demographics
NPI:1649314618
Name:JACOBS STUTHERS, ABBY (RN, NP)
Entity type:Individual
Prefix:MS
First Name:ABBY
Middle Name:
Last Name:JACOBS STUTHERS
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. VINCENT'S HOSPITAL, DEPT. OF COMMUNITY MEDICINE
Mailing Address - Street 2:170 WEST 12TH ST
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:212-604-7627
Practice Address - Street 1:ST. VINCENT'S HOSPITAL, DEPT. OF COMMUNITY MEDICINE
Practice Address - Street 2:170 WEST 12TH ST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8073
Practice Address - Fax:212-604-7627
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400399-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health