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NPI Code Detail

MEDICARE: DR. JESSICA DENISSE VAZQUEZ DNP, FNP-BC, PMHNP

MEDICARE: DR. JESSICA DENISSE VAZQUEZ DNP, FNP-BC, PMHNP
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
1363LF0000XFamily Nurse PractitionerLG-0011496PA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerL8-0010884DE

General Provider Information

NPI Number : 1801442470
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA DENISSE VAZQUEZ DNP, FNP-BC, PMHNP
Provider Business Mailing Address
First Line : 1900 N 9TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-2024
Country : US
Telephone Number : 267-259-3373
Fax Number :
Provider Business Practice Location Address
First Line : 1900 N 9TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-2024
Country : US
Telephone Number : 267-259-3373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2019
Last Update Date : 01/29/2026

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Directions to “ DR. JESSICA DENISSE VAZQUEZ DNP, FNP-BC, PMHNP” Practice Location

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