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General NPI Number Information
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NPI Number | 1073644910
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Entity Type | Individual
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Provider Name | JESSICA HEATHER EMERALD RN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15315 WOODLAWN MANOR CT
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City | CYPRESS
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State | TX
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Zip | 77429-4986
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Country | US
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Telephone | 281-256-7449
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Fax |
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Provider Business Mailing Address
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Address Line | 15315 WOODLAWN MANOR CT
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City | CYPRESS
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State | TX
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Zip | 77429-4986
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Country | US
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Telephone | 281-256-7449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 648369
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License Number State | TX
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