Doctor Name: | JESSICA RISPOLI |
NPI Number: | 1053779504 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SP015900 |
Business Practice Address: | 101 Pocono Cmns Ste 101 Stroudsburg, PA - 183607599 |
Business Phone Number: | 5708729955 |
Business Fax Number: | |
Mailing Address: | 101 Pocono Cmns Ste 101, STROUDSBURG |
State: | PA |
Postal Code: | 183607599 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/29/2016 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP015900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |