Provider Demographics
NPI:1861054140
Name:MILAZZO, JESSICA MARIE (MSN, RN, CDCES)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:MILAZZO
Suffix:
Gender:F
Credentials:MSN, RN, CDCES
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:BICKFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 FRANKLIN ST STE 180
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4341
Practice Address - Country:US
Practice Address - Phone:814-534-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN537361163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator