Individual
KATELYN ALICE JESUKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-9558
Mailing address
111 S 11TH ST, STE 8490, PHILADELPHIA, PA 19107-4824
(215) 952-9558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP019873
PA
Other
Enumeration date
01/30/2019
Last updated
01/23/2020
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