Individual
JESSICA VANETESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
264 GRANITE RUN DR, LANCASTER, PA 17601-6804
(717) 721-8205
(717) 721-8251
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 721-8205
(717) 721-8251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004917
VA
363A00000X
Physician Assistant
MA057163
—
363A00000X
Physician Assistant
OA003392
—
363AM0700X
Medical Physician Assistant
Primary
MA057163
PA
Other
Enumeration date
09/18/2014
Last updated
07/06/2020
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