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Individual
JESSICA RAY NUNNALLY
Active
Individual
JESSICA RAY NUNNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AG1215007
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95003512
LIC
CA
Enumeration date
02/29/2016
Last updated
07/19/2018
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