Healthcare Provider Details

I. General information

NPI: 1891216404
Provider Name (Legal Business Name): JESSICA ANN VISCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 E WASHINGTON ROW
SANDUSKY OH
44870-2609
US

IV. Provider business mailing address

167 E WASHINGTON ROW
SANDUSKY OH
44870-2609
US

V. Phone/Fax

Practice location:
  • Phone: 419-341-3406
  • Fax: 419-355-9443
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022093
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN.341873
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: