Provider Demographics
NPI:1922799501
Name:SCHWAB, JESSICA MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:415 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9693
Mailing Address - Country:US
Mailing Address - Phone:215-908-3516
Mailing Address - Fax:
Practice Address - Street 1:3601 S CONGRESS AVE STE C200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7299
Practice Address - Country:US
Practice Address - Phone:215-908-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012350363LF0000X
PASP027349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily