Provider Demographics
NPI:1578013819
Name:BARTELLA, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BARTELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9442 NOONAN ST
Mailing Address - Street 2:LOT 620
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7023
Mailing Address - Country:US
Mailing Address - Phone:563-552-9662
Mailing Address - Fax:
Practice Address - Street 1:9442 NOONAN ST
Practice Address - Street 2:LOT 620
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7023
Practice Address - Country:US
Practice Address - Phone:563-552-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health