Individual
MS. JESSICA PLICHTA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, APRN-PMH
Contact information
Practice address
10235 S PADRE ISLAND DR, CORPUS CHRISTI, TX 78418-4454
(361) 937-1010
(361) 937-1296
Mailing address
17051 MERCY DR STE 204, EAGLE RIVER, AK 99577-7631
(361) 537-3339
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
221394
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
735117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NP7501
BC/BS-TX
TX
05
—
208391703
—
TX
01
—
221394
APRN LICENSE
AK
01
—
TXB144721
MEDICARE PTAN
—
Enumeration date
11/09/2006
Last updated
06/17/2024
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