MEDICARE: JESSICA BARTKO

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
1	363LF0000X	Family Nurse Practitioner	SP013857	PA

General Provider Information

NPI Number	:	1497142228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BARTKO

Provider Business Mailing Address
First Line	:	4401 PENN AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-1334
Country	:	US
Telephone Number	:	412-692-7368
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 HIGH RD
Second Line	:
City	:	JEFFERSON HILLS
State	:	PA
Zip	:	15025-3526
Country	:	US
Telephone Number	:	412-405-9363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	04/20/2015

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