MS. JESSICA PRUDENCIO PMHNP-BC NPI 1215749486

NPI Information

  • NPI: 1215749486
  • Provider Name: MS. JESSICA PRUDENCIO, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 224 MILLER AVE
    FREEPORT, NY
    ZIP 11520
  • Phone: (516) 728-0333

Map and Directions

Get Directions

NPI Details

MS. Jessica Prudencio, PMHNP-BC is a psychiatric/mental health nurse practitioner in Freeport, NY. MS. Jessica Prudencio, PMHNP-BC NPI is 1215749486. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

224 MILLER AVE
FREEPORT, NY
ZIP 11520-530
Phone: (516) 728-0333

The enumeration date for this NPI number is 1/23/2025 and was last updated on 1/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthF406381-01NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.