JESSICA LYN PERCOCO (NPI# 1679127211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679127211 |
| Entity Type | Individual |
| Full Name | JESSICA LYN PERCOCO |
| Credential | CRNP |
| Practice Address |
700 High Street Williamsport PA 17701 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703212850 |
| Mailing Telephone | 5703268723 |
| Mailing Fax Number | 5703268922 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN698069 | PA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP020746 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
700 HIGH STREET |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083677868 | Susquehanna Physician Services | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2006-04-11 |
| 1619440971 | Debra Kay Canellos | Nurse Practitioner | 700 High Street, Williamsport, PA 17701-3198 | 2019-01-09 |
| 1013351378 | Timothy Edward Wirth | Pharmacist | 700 High Street, Pharmacy Department, Williamsport, PA 17701 | 2013-04-17 |
| 1760730824 | Alana E John | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2012-08-21 |
| 1639432628 | Ashley Nichole Pence | Pediatrics | 700 High Street, Williamsport, PA 17701-3198 | 2012-06-25 |
| 1912266685 | Brent M Carpenter | Nurse Anesthetist, Certified Registered | 700 High Street, Williamsport, PA 17701-3198 | 2012-05-15 |
| 1235366857 | Susquehanna Physician Services | Physician Assistant | 700 High Street, Williamsport, PA 17701-3198 | 2009-06-22 |
| 1518113570 | Marissa Lara Ambron | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2008-08-11 |
| 1497962286 | Puneet Gupta | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2007-05-17 |
| 1285719559 | Upmc Williamsport | Clinic/Center | 700 High Street, Williamsport, PA 17701-3198 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760941355 | Theresa Hershberger | Nurse Practitioner | 1100 Grampian Blvd Fl 3, Williamsport, PA 17701-1909 | 2019-03-14 |
| 1053910711 | Taylor Anne Yagel | Nurse Practitioner | 131 W Edwin St, Williamsport, PA 17701-6131 | 2020-10-22 |
| 1619440971 | Debra Kay Canellos | Nurse Practitioner | 700 High Street, Williamsport, PA 17701-3198 | 2019-01-09 |
| 1235611625 | Jeffrey M Tessman | Nurse Practitioner | 412 N Monroe St, Williamsport, IN 47993-1049 | 2018-08-31 |
| 1730671462 | Sarah Updegraff | Nurse Practitioner | 471 Hepburn St, Williamsport, PA 17701-6122 | 2018-05-30 |
| 1437653557 | Kelle Rae Steinbacher | Nurse Practitioner | 2300 E 3rd St, Williamsport, PA 17701-4004 | 2018-03-22 |
| 1235631490 | Holly Shadle | Nurse Practitioner | 740 High Street, Suite 3002, Williamsport, PA 17701-3102 | 2018-03-05 |
| 1073013785 | Jaclyn Craigin | Nurse Practitioner | 1731 Ringer Ln, Williamsport, IN 47993-8900 | 2018-02-19 |
| 1396263778 | Jennifer Renee Burnett | Nurse Practitioner | 3 Byrkit Dr, Williamsport, MD 21795-1158 | 2017-09-06 |
| 1659823953 | Leslie Erdman | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2016-11-03 |
| Find all providers in WILLIAMSPORT | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.