Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Colletta Latoya Jerrick, NURSEPRACTITIONER

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1922720887

Colletta Latoya Jerrick, NURSEPRACTITIONER is a Psychiatric/Mental Health Nurse Practitioner in Bay Shore, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022

Practice location Address checks out

1548 E Forks Rd
Bay Shore, NY 11706-3144
Phone: (631) 308-7658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F403813-01 (NY)

Record details

NPI number1922720887
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedSeptember 16, 2022
Last updated in NPPESSeptember 16, 2022
Certification dateSeptember 15, 2022

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