Jessica Marie Mischello, RN
Individual provider Active NPI Emergency Registered Nurse · Old Forge, PA
NPI 1639758014 · NPPES record last updated Apr 5, 2021
Key facts
- NPI
- 1639758014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Registered Nurse 163WE0003X
- License
- RN711873 (PA)
- Practice address
- 403 S Main St
Old Forge, PA 18518-1608 - Phone
- (570) 457-0844
- NPI assigned
- Apr 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN711873 | PA | MD | Emergency Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Pennsylvania LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | RN711873 | PA | Yes |
Addresses
Primary practice location
403 S Main St
Old Forge, PA 18518-1608
Mailing address
512 Moosic Rd
Old Forge, PA 18518-2027
Phone (570) 466-7539
Other providers in Old Forge, PA
- Shawn McNamara
- Megan L Merrick
- Michael a Jalowiec DO PC
- Michele L Domiano OD PC
- James M Minella
- Dana Marie Montgomery
- NCHS, Inc.
- Nicole Dunbar Brush
- Noskco Inc
- Robert James Notari
All providers in Old Forge, PA · Emergency Registered Nurse in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2021. 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.