Provider Demographics
NPI:1982468401
Name:INNOVATIVE CARE, NP IN FAMILY HEALTH, PLLC
Entity Type:Organization
Organization Name:INNOVATIVE CARE, NP IN FAMILY HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VILSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:917-239-3094
Mailing Address - Street 1:1712 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6408
Mailing Address - Country:US
Mailing Address - Phone:917-239-3094
Mailing Address - Fax:718-287-4600
Practice Address - Street 1:1712 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6408
Practice Address - Country:US
Practice Address - Phone:917-239-3094
Practice Address - Fax:718-287-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty