Basic Information
| Provider Information | |||||||||
| NPI: | 1164016804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JESKO | ||||||||
| FirstName: | ALEXA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSN, APRN, WHNP-BC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JESKO | ||||||||
| OtherFirstName: | ALEXANDRA | ||||||||
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| OtherCredential: | MSN, APRN, WHNP-BC | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3066 E COMMERCE ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782201013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102337000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2810 DACY LN | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786406322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122688900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2021 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN289992 | GA | N | Nursing Service Providers | Registered Nurse | 363LW0102X | 1030789 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.