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Individual
JESSICA WUKASCH
Active
Individual
JESSICA WUKASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106377
CT
163W00000X
Registered Nurse
1117405
AL
163W00000X
Registered Nurse
196729
TN
163W00000X
Registered Nurse
800037
TX
363L00000X
Nurse Practitioner
Primary
1117405
AL
363LF0000X
Family Nurse Practitioner
005027
CT
363LF0000X
Family Nurse Practitioner
17946
TN
363LF0000X
Family Nurse Practitioner
98172
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236346
—
CT
05
—
1533415
—
TN
Enumeration date
07/27/2012
Last updated
05/09/2023
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