MEDICARE: JESSICA BETH ARMSTRONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	735868	CA

General Provider Information

NPI Number	:	1134366099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BETH ARMSTRONG

Provider Business Mailing Address
First Line	:	1420 E GLENLAKE LN
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-3574
Country	:	US
Telephone Number	:	559-779-0918
Fax Number	:	559-298-1551

Provider Business Practice Location Address
First Line	:	1420 E GLENLAKE LN
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-3574
Country	:	US
Telephone Number	:	559-779-0918
Fax Number	:	559-298-1551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

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