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NPI Code Detail

MEDICARE: JESSICA LOUISE SOMERVILLE NP

MEDICARE:   JESSICA LOUISE SOMERVILLE  NP
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
1363LF0000XFamily Nurse Practitioner1113541TX

General Provider Information

NPI Number : 1194402362
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LOUISE SOMERVILLE NP
Provider Business Mailing Address
First Line : 2205 REBEL RD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5218
Country : US
Telephone Number : 512-670-6698
Fax Number :
Provider Business Practice Location Address
First Line : 3010 BEE CAVES RD STE 200
Second Line :
City : AUSTIN
State : TX
Zip : 78746-5526
Country : US
Telephone Number : 512-600-9898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/29/2023

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Directions to “ JESSICA LOUISE SOMERVILLE NP” Practice Location

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