Healthcare Provider Details

I. General information

NPI: 1043151095
Provider Name (Legal Business Name): JESSICA NICOLAZZO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 COAL VALLEY RD STE 209A
JEFFERSON HILLS PA
15025-3703
US

IV. Provider business mailing address

575 COAL VALLEY ROAD SUITE 300
CLAIRTON PA
15025-3770
US

V. Phone/Fax

Practice location:
  • Phone: 412-267-6600
  • Fax:
Mailing address:
  • Phone: 412-267-6600
  • Fax: 412-267-6281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010909
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010909
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: