Individual
MRS. JESSETTA JOSWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-6863
(417) 820-6868
Mailing address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-6863
(417) 820-6868
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
605872
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659360428
—
MO
05
—
175742001
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00689763
RAILROAD MEDICARE
—
Enumeration date
10/14/2005
Last updated
05/21/2009
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