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NPI Code Detail

MEDICARE: JESSICA RASSAS APRN

MEDICARE: JESSICA RASSAS APRN
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
1363LP2300XPrimary Care Nurse Practitioner257617AZ
2363LF0000XFamily Nurse PractitionerN370083039WA
3363LF0000XFamily Nurse Practitioner257617AZ
4163WG0000XGeneral Practice Registered NurseRN163765AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN163765OTHERAZAZBN
2257617OTHERAZARIZONA STATE BOARD OF NURSING

General Provider Information

NPI Number : 1841885118
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA RASSAS APRN
Provider Business Mailing Address
First Line : 4742 E INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-5440
Country : US
Telephone Number : 602-840-2950
Fax Number :
Provider Business Practice Location Address
First Line : 4742 E INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-5440
Country : US
Telephone Number : 602-840-2950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2021
Last Update Date : 01/02/2026

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