Provider Demographics
NPI:1316786940
Name:JAWORSKI, JESSICA LINDSAY (AGACNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LINDSAY
Last Name:JAWORSKI
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:109 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-1335
Mailing Address - Country:US
Mailing Address - Phone:419-787-8047
Mailing Address - Fax:
Practice Address - Street 1:6546 WEATHERFIELD CT
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9252
Practice Address - Country:US
Practice Address - Phone:419-491-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036468363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care