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NPI Code Detail

MEDICARE: MRS. JESSICA MARSHALL-MORENO FNP-C

MEDICARE:  MRS. JESSICA  MARSHALL-MORENO  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP128360TX

General Provider Information

NPI Number : 1740663491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA MARSHALL-MORENO FNP-C
Provider Business Mailing Address
First Line : 5402 S STAPLES
Second Line : SUITE 103
City : CORPUS CHRISTI
State : TX
Zip : 78411-4656
Country : US
Telephone Number : 361-980-1299
Fax Number : 361-986-8988
Provider Business Practice Location Address
First Line : 14041 NORTHWEST BLVD
Second Line : #1
City : CORPUS CHRISTI
State : TX
Zip : 78410-5137
Country : US
Telephone Number : 361-767-9963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 07/07/2017

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Directions to “ MRS. JESSICA MARSHALL-MORENO FNP-C” Practice Location

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