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NPI Code Detail

MEDICARE: MARTHA JESSOP APRN-FNP, BC

MEDICARE: MARTHA JESSOP APRN-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
1363LF0000XFamily Nurse Practitioner5855479-4405UT
2363LF0000XFamily Nurse Practitioner100598MT

General Provider Information

NPI Number : 1801123534
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA JESSOP APRN-FNP, BC
Provider Business Mailing Address
First Line : 8299 MT HIGHWAY 35
Second Line :
City : BIGFORK
State : MT
Zip : 59911-3583
Country : US
Telephone Number : 406-837-5541
Fax Number :
Provider Business Practice Location Address
First Line : 8299 MT HIGHWAY 35
Second Line :
City : BIGFORK
State : MT
Zip : 59911-3583
Country : US
Telephone Number : 406-837-5541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2009
Last Update Date : 11/27/2023

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