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Individual

JESSICA LYNN NOVAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2233 STATE ROUTE 86, SARANAC LAKE, NY 12983-5644
(518) 891-4141
Mailing address
731 S DOUGLAS ST, SALT LAKE CITY, UT 84102-3717
(201) 248-1689

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
103163453102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
786233
NY

Other

Enumeration date
10/19/2019
Last updated
12/22/2021
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