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NPI Code Detail

MEDICARE: JESSICA ORLENE MAHONEY COOMBS FNP-BC

MEDICARE:   JESSICA ORLENE MAHONEY COOMBS  FNP-BC
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
1363L00000XNurse Practitioner1061358TX

General Provider Information

NPI Number : 1487369419
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ORLENE MAHONEY COOMBS FNP-BC
Provider Business Mailing Address
First Line : 7104 CHAMBERS CREEK LN
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-4018
Country : US
Telephone Number : 817-675-6174
Fax Number :
Provider Business Practice Location Address
First Line : 7104 CHAMBERS CREEK LN
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-4018
Country : US
Telephone Number : 817-675-6174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2023
Last Update Date : 01/13/2023

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Directions to “ JESSICA ORLENE MAHONEY COOMBS FNP-BC” Practice Location

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