Individual
MS. JESSICA I ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11141 PARKVIEW PLAZA DR, SUITE 310, FORT WAYNE, IN 46845-1713
(260) 266-8840
(260) 266-8849
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002924A
IN
363LF0000X
Family Nurse Practitioner
28133197A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000611343
ANTHEM
IN
05
—
200938600
—
IN
01
—
P00737805
MEDICARE RR
IN
Enumeration date
10/03/2006
Last updated
10/17/2022
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