Provider Demographics
NPI:1992787469
Name:FIELDS, JO ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
Last Name:FIELDS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W 85TH ST
Mailing Address - Street 2:APT. 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4126
Mailing Address - Country:US
Mailing Address - Phone:212-799-0830
Mailing Address - Fax:
Practice Address - Street 1:121 AVENUE OF THE AMERICAS
Practice Address - Street 2:AHC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1510
Practice Address - Country:US
Practice Address - Phone:212-941-9090
Practice Address - Fax:212-941-9614
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420335-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health