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Individual

JESSICA KOMISOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 S JUNIPER ST FL 3, PHILADELPHIA, PA 19107-1316
(866) 849-0692
Mailing address
PO BOX 211699, EAGAN, MN 55121-3699

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1116205
TX
163W00000X
Registered Nurse
293416
AZ
163W00000X
Registered Nurse
RN.526520
OH
163W00000X
Registered Nurse
Primary
RN632848
PA
163W00000X
Registered Nurse
RN9628573
FL

Other

Enumeration date
08/14/2024
Last updated
08/14/2024
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