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Individual
BRISA SALOME JESSUP
Active
Individual
BRISA SALOME JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
10008584
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
10008584
OR
363LP0222X
Critical Care Pediatric Nurse Practitioner
10008584
OR
Other
Enumeration date
05/24/2023
Last updated
07/17/2023
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