Healthcare Provider Details

I. General information

NPI: 1386363505
Provider Name (Legal Business Name): JESSICA STEELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA CONRAD

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 MAIN ST
GREENVILLE PA
16125-2608
US

IV. Provider business mailing address

100 SHENANGO AVE
SHARON PA
16146-1503
US

V. Phone/Fax

Practice location:
  • Phone: 724-588-5250
  • Fax: 724-588-5253
Mailing address:
  • Phone: 724-588-5250
  • Fax: 724-588-5253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP025976
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP025976
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: