Individual
MRS. JESSICA BROOKE SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP-PC
Contact information
Practice address
7777 FOREST LN STE C300J, DALLAS, TX 75230-2604
(972) 566-2043
(972) 566-7437
Mailing address
7777 FOREST LN STE C300J, DALLAS, TX 75230-2604
(972) 566-7730
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP117352
TX
363LP0200X
Pediatric Nurse Practitioner
689425
TX
Other
Enumeration date
12/03/2008
Last updated
05/28/2024
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