National Provider Identifier
Jerry L Corp II, PMHNP-BC
Jerry L Corp II, PMHNP-BC is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 884-0888.
Profile Overview
- NPI
- 1003261322
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- April 25, 2016
- Last Updated
- February 07, 2020
Practice Location
- 255 Delaware Ave
- Buffalo, NY 14202-2016
Phone: (716) 884-0888
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Full Record
- NPI
- 1003261322
- Entity Type
- Individual
- Last Name
- Corp
- First Name
- Jerry
- Middle Name
- L
- Name Prefix
- Mr.
- Name Suffix
- II
- Credential
- PMHNP-BC
- Mailing Street Address
- 255 Delaware Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14202-2016
- Mailing Country
- US
- Mailing Phone
- (716) 884-0888
- Practice Street Address
- 255 Delaware Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14202-2016
- Practice Country
- US
- Practice Phone
- (716) 884-0888
- Enumeration Date
- April 25, 2016
- Last Updated
- February 07, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- February 07, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)