Provider Demographics
NPI:1720623481
Name:NURSE, JASMINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:NURSE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 PITKIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-4539
Mailing Address - Country:US
Mailing Address - Phone:718-495-1122
Mailing Address - Fax:718-495-0022
Practice Address - Street 1:1538 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-4539
Practice Address - Country:US
Practice Address - Phone:718-495-1122
Practice Address - Fax:718-495-0022
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY066273OtherPHARMACIST