Provider Demographics
NPI:1194078436
Name:BERNSTEIN, JESSIE (NP)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2118
Mailing Address - Country:US
Mailing Address - Phone:781-431-2345
Mailing Address - Fax:781-239-9966
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:SUITE 500
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2118
Practice Address - Country:US
Practice Address - Phone:781-431-2345
Practice Address - Fax:781-239-9966
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2271435363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner