Individual
MRS. JESSICA LYNNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7014
Mailing address
21 BUTTERNUT DR, HATBORO, PA 19040-1513
(215) 920-1789
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
RN585570
PA
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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