COLLETTA LATOYA JERRICK NURSE PRACTITIONER
NPI 1922720887
Nurse Practitioner - Psychiatric/Mental Health in Bay Shore, NY

Q: What is Colletta Jerrick's NPI number?

The NPI number for Colletta Jerrick is 1922720887. It was assigned to this individual provider in the NPPES registry on September 16, 2022.

Q: What is Colletta Jerrick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Colletta Jerrick was last updated on September 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 16, 2022

1548 E FORKS RD, BAY SHORE, NY 11706(631) 308-7658 Get Directions Write a Review

NPPES record last updated: September 16, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Colletta Latoya Jerrick Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLETTA LATOYA JERRICK NURSE PRACTITIONER (NPI 1922720887) is an individual psychiatric/mental health provider in Bay Shore, New York, licensed in New York (F403813-01) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1922720887

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameCOLLETTA LATOYA JERRICKCredential: NURSE PRACTITIONER

Location Address1548 E FORKS RDBay Shore, NY 11706-3144

Mailing Address1548 E Forks RdBay Shore, NY 11706-3144 · (631) 308-7658

Phone(631) 308-7658

Sole ProprietorYes

Enumeration DateSeptember 16, 2022

NPPES CertifiedSeptember 15, 2022

✔ NPI 1922720887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · F403813-01

1548 E FORKS RD, Bay Shore, NY 11706

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Other Identifiers 1

OtherF403813-01NY · New York State Office Of The Professions

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colletta Jerrick's NPI number?

The NPI number for Colletta Jerrick is 1922720887. It was assigned to this individual provider in the NPPES registry on September 16, 2022.

Where is Colletta Jerrick located?

Colletta Jerrick practices at 1548 E Forks Rd, Bay Shore, NY 11706. The listed phone number is (631) 308-7658.

What is Colletta Jerrick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Colletta Jerrick was last updated on September 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.