Individual
JESSICA HACKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-3817
(682) 885-3825
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
AP122457
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP122457
TX
Other
Enumeration date
09/14/2012
Last updated
04/06/2021
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