Provider Demographics
NPI:1972155000
Name:CAWTHARD, JESSICA M (FNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:CAWTHARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-3522
Mailing Address - Country:US
Mailing Address - Phone:585-944-3708
Mailing Address - Fax:
Practice Address - Street 1:3916 VINEYARD DR
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-3522
Practice Address - Country:US
Practice Address - Phone:585-944-3708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344638-01363L00000X
NY344638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner