MEDICARE: JESSICA RENEE-PANGRAZIO NURSE PRACTITIONER IN ADULT HEALTH PLLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1972460400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA RENEE-PANGRAZIO NURSE PRACTITIONER IN ADULT HEALTH PLLC

Provider Business Mailing Address
First Line	:	130 CANAL LANDING BLVD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5121
Country	:	US
Telephone Number	:	585-488-5850
Fax Number	:	585-735-4632

Provider Business Practice Location Address
First Line	:	130 CANAL LANDING BLVD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5121
Country	:	US
Telephone Number	:	585-488-5850
Fax Number	:	585-735-4632

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JESSICA RACHOW-PANGRAZIO
Credential	:	DNP
Telephone Number	:	585-488-5850

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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