Healthcare Provider Details

I. General information

NPI: 1285026997
Provider Name (Legal Business Name): JESSICA NOTTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA RAPPENO RN

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 FREEDOM CT APT L
UTICA NY
13502-1688
US

IV. Provider business mailing address

40 FREEDOM CT APT L
UTICA NY
13502-1688
US

V. Phone/Fax

Practice location:
  • Phone: 585-455-1676
  • Fax:
Mailing address:
  • Phone: 585-455-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number8249
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101-0109063
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number071258-23
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number309290
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: