Individual
MRS. ANNA REGINA JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
2120 N MAYS ST, SUITE 450, ROUND ROCK, TX 78664-2192
(512) 828-4405
(512) 828-4412
Mailing address
2120 N MAYS ST, SUITE 450, ROUND ROCK, TX 78664-2192
(512) 828-4405
(512) 828-4412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
669251
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021NP
BCBS
TX
Enumeration date
05/23/2007
Last updated
12/28/2007
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