Provider Demographics
NPI:1437554920
Name:KESSINGER, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KESSINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1638
Mailing Address - Country:US
Mailing Address - Phone:814-684-5000
Mailing Address - Fax:
Practice Address - Street 1:1365 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1638
Practice Address - Country:US
Practice Address - Phone:814-684-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044866L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist