Provider Demographics
NPI:1912760380
Name:CROMWELL, JESSICA CECILIA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CECILIA
Last Name:CROMWELL
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 1:294 SRUTHI DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-8008
Mailing Address - Country:US
Mailing Address - Phone:559-541-0857
Mailing Address - Fax:
Practice Address - Street 1:294 SRUTHI DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-8008
Practice Address - Country:US
Practice Address - Phone:559-541-0857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator