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Individual
MR. JESSE KORTH
Active
Individual
MR. JESSE KORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
238714
NC
163WC0200X
Critical Care Medicine Registered Nurse
87827
WV
163WC0200X
Critical Care Medicine Registered Nurse
95028029
CA
363LF0000X
Family Nurse Practitioner
Primary
95012974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95012974
BOARD OF NURSING NP LICENSE
CA
01
—
95029028
BOARD OF NURSING
CA
Enumeration date
09/09/2017
Last updated
12/30/2019
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