Jessica Jawidzik, APRN, DNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Williston, VT
NPI 1235790874 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1235790874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 101.0134482 (VT)
- Practice address
- 4185 St George Rd
Williston, VT 05495-7695 - Phone
- (802) 266-4465
- Fax
- (802) 531-3226
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101.0134482 | VT | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 101.0134482 | VT | Yes |
Addresses
Primary practice location
4185 St George Rd
Williston, VT 05495-7695
Mailing address
4185 St George Rd
Williston, VT 05495-7695
Phone (802) 266-4465
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6704412 | Medicaid | VT |
Other providers in Williston, VT
- Kramer Jakubek
- Jacqueline Jancaitis
- Callan Janowiec
- Adrienne Jarvis
- Danielle Jasinski
- Megan Jensen
- Jennifer Johnson
- Michael C Johnson
- Alexandra M Jones
- Jennifer Leary Jones
All providers in Williston, VT · Psychiatric/Mental Health Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.