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General NPI Number Information
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NPI Number | 1821585613
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Entity Type | Individual
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Provider Name | JESSICA MARIE FAKHOURY
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Gender | Female
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 75 HOSPITAL DR STE 260
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City | ATHENS
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State | OH
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Zip | 45701-2866
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Country | US
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Telephone | 740-594-8819
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Fax | 740-594-4099
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | TBD
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71011369A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0036255
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License Number State | OH
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