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Individual
JESSIE PENG
Active
Individual
JESSIE PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95176159
CA
363L00000X
Nurse Practitioner
Primary
NP95011315
CA
363LF0000X
Family Nurse Practitioner
95011315
CA
363LF0000X
Family Nurse Practitioner
AP60937038
WA
363LF0000X
Family Nurse Practitioner
APRN.CNP.024197
OH
Other
Enumeration date
03/08/2019
Last updated
01/29/2021
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