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Individual
JEENA ISSAC
Active
Individual
JEENA ISSAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP129897
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371434702
—
TX
01
—
8KI702
BCBS
TX
Enumeration date
04/14/2016
Last updated
01/22/2019
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