Healthcare Provider Details

I. General information

NPI: 1821650771
Provider Name (Legal Business Name): JASMINE KEYANTE HOSKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 PHALEN BLVD
SAINT PAUL MN
55106-2126
US

IV. Provider business mailing address

5385 WESTHEIMER RD
HOUSTON TX
77056-5402
US

V. Phone/Fax

Practice location:
  • Phone: 612-819-0597
  • Fax: 651-493-4221
Mailing address:
  • Phone: 832-602-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141791
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: