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Individual

JESSICA LYNN VESA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
540 PARMALEE AVE STE 610, YOUNGSTOWN, OH 44510-1605
(330) 744-4369
(330) 744-1728
Mailing address
PO BOX 4012, YOUNGSTOWN, OH 44515-0012
(330) 270-2350

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.360816
OH
163W00000X
Registered Nurse
Primary
RN360816
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0421475
OH
01
34-1706671
TAX ID
Enumeration date
10/02/2020
Last updated
02/22/2021
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