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Individual

JESSA IRENE DAURIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
217 N AURORA ST, ITHACA, NY 14850-4345
(607) 273-2811
Mailing address
218 S ALBANY ST, APT 2, ITHACA, NY 14850-5404
(206) 724-2305

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60116854
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9664202
WA
Enumeration date
11/17/2009
Last updated
01/07/2013
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