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Individual
MS. NICOLE RUTH JESSEN
Active
Individual
MS. NICOLE RUTH JESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT, PES
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
AT.003428
OH
2255A2300X
Athletic Trainer
Primary
AT003428
OH
2255A2300X
Athletic Trainer
AT9279
TX
Other
Enumeration date
03/15/2011
Last updated
04/17/2023
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