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General NPI Number Information
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NPI Number | 1316707128
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Entity Type | Individual
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Provider Name | JESSICA MCCRORK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 301 HILLSDALE CIR
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City | WADSWORTH
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State | OH
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Zip | 44281-1009
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Country | US
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Telephone | 234-817-0624
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 MASSILLON RD STE 300
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City | UNIONTOWN
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State | OH
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Zip | 44685-7854
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Country | US
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Telephone | 234-204-5150
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Fax | 330-634-1329
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0036067
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License Number State | OH
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