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General NPI Number Information
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NPI Number | 1366258295
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Entity Type | Individual
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Provider Name | JESSICA GRACE TECSON APRN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5672
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Country | US
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Telephone | 973-322-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2040
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City | UNION
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State | NJ
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Zip | 07083-2040
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Country | US
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Telephone | 973-699-6151
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15260900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR19472800
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License Number State | NJ
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