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Individual
DR. JESSICA GIDDENS
Active
Individual
DR. JESSICA GIDDENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277000634
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277000634
STATE LICENSE IL
IL
01
—
377000614
IL PRESCRIBING LICENSE
IL
01
—
6555912834012
SURESCRIPTS
IL
Enumeration date
09/12/2013
Last updated
09/16/2024
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