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NPI Code Detail

MEDICARE: JEWEL BERNADETH CONCEPCION

MEDICARE: JEWEL BERNADETH CONCEPCION
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
1163W00000XRegistered NurseRN60674930WA
2363LF0000XFamily Nurse PractitionerAP61553733WA

General Provider Information

NPI Number : 1588429633
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEWEL BERNADETH CONCEPCION
Provider Business Mailing Address
First Line : 1338 FOREMAN RD
Second Line :
City : DUPONT
State : WA
Zip : 98327-8802
Country : US
Telephone Number : 510-396-1760
Fax Number :
Provider Business Practice Location Address
First Line : 1649 E 72ND ST
Second Line :
City : TACOMA
State : WA
Zip : 98404-5402
Country : US
Telephone Number : 253-472-9027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2024
Last Update Date : 04/29/2024

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Directions to “ JEWEL BERNADETH CONCEPCION ” Practice Location

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