Provider Demographics
NPI:1659927903
Name:GREEN, JESSICA LYNN (RN; BSN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:GREEN
Suffix:
Gender:F
Credentials:RN; BSN
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:KAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 WESTTOWN RD STE 290
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4991
Mailing Address - Country:US
Mailing Address - Phone:610-344-6252
Mailing Address - Fax:610-344-6727
Practice Address - Street 1:601 WESTTOWN RD STE 180
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4991
Practice Address - Country:US
Practice Address - Phone:610-344-6225
Practice Address - Fax:610-344-6727
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN523483L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse