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NPI Code Detail

MEDICARE: MRS. JESSICA MARIE STEPHENS FNP-C

MEDICARE:  MRS. JESSICA MARIE STEPHENS  FNP-C
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 PractitionerAP128333TX
2363LF0000XFamily Nurse PractitionerAP128333TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AP128333OTHERTXLICENSE

General Provider Information

NPI Number : 1578947552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA MARIE STEPHENS FNP-C
Provider Business Mailing Address
First Line : 1005 NEDERLAND AVE
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-2832
Country : US
Telephone Number : 409-299-5288
Fax Number : 409-237-5169
Provider Business Practice Location Address
First Line : 1005 NEDERLAND AVE
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-2832
Country : US
Telephone Number : 409-299-5288
Fax Number : 409-237-5169
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2015
Last Update Date : 03/27/2026

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