Individual
JESSICA VANSCOYOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 COMMONWEALTH CIR, GRAND PRAIRIE, TX 75052-3355
(765) 366-1631
Mailing address
209 COMMONWEALTH CIR, GRAND PRAIRIE, TX 75052-3355
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
1168659
TX
Other
Enumeration date
03/01/2025
Last updated
03/01/2025
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