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General NPI Number Information
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NPI Number | 1346723533
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Entity Type | Individual
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Provider Name | JESSICA R DENNISON RN BSN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 19 LAKES STREET
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City | NESPELEM
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State | WA
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Zip | 99155
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Country | US
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Telephone | 509-634-2900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71
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City | NESPELEM
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State | WA
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Zip | 99155-0071
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 258165
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License Number State | NC
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