MEDICARE: JESSICA LANGSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD468876	PA

General Provider Information

NPI Number	:	1962933283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LANGSTON

Provider Business Mailing Address
First Line	:	11279 PERRY HWY STE 450
Second Line	:	LEVEL 3 COW POD
City	:	WEXFORD
State	:	PA
Zip	:	15090-9303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 CRANBERRY SPRINGS DR STE 100
Second Line	:	LEVEL 3 COW POD
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-6687
Country	:	US
Telephone Number	:	724-720-3098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	05/21/2021

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Directions to “ JESSICA LANGSTON ” Practice Location

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