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NPI Code Detail

MEDICARE: JESSICA R STEFANIC CRNP

MEDICARE: JESSICA R STEFANIC CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN56548PA
2363L00000XNurse PractitionerSP012546PA
3363LF0000XFamily Nurse PractitionerSP012546PA

General Provider Information

NPI Number : 1083963862
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA R STEFANIC CRNP
Provider Business Mailing Address
First Line : 409 S 2ND ST STE 2F
Second Line :
City : HARRISBURG
State : PA
Zip : 17104-1612
Country : US
Telephone Number : 717-791-2520
Fax Number : 717-703-0061
Provider Business Practice Location Address
First Line : 4310 LONDONDERRY RD STE 202
Second Line :
City : HARRISBURG
State : PA
Zip : 17109-5329
Country : US
Telephone Number : 717-791-2520
Fax Number : 717-920-4361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2012
Last Update Date : 12/19/2020

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Directions to “ JESSICA R STEFANIC CRNP” Practice Location

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