Individual
JESSICA RENEE SANSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
311 W 24TH ST STE 101, ERIE, PA 16502-2668
(814) 452-4214
(814) 459-7823
Mailing address
311 W 24TH ST STE 101, ERIE, PA 16502-2668
(144) 524-2148
(814) 459-7823
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057882
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093733933
GROUP NPI
PA
Enumeration date
09/23/2015
Last updated
10/05/2020
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