Individual
JESSICA SUSANA NEDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
176219
CO
363LF0000X
Family Nurse Practitioner
Primary
10334
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37179870
—
CO
Enumeration date
07/13/2010
Last updated
01/15/2026
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