Basic Information
| Provider Information | |||||||||
| NPI: | 1841955986 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REESE | ||||||||
| FirstName: | JESSICA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5012 S US HIGHWAY 75, SUITE 300 | ||||||||
| Address2: | ATTN BILLING | ||||||||
| City: | DENISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750204587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034161726 | ||||||||
| FaxNumber: | 9034161718 | ||||||||
| Practice Location | |||||||||
| Address1: | 5012 S US HIGHWAY 75 STE 250 | ||||||||
| Address2: | |||||||||
| City: | DENISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750204587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034166430 | ||||||||
| FaxNumber: | 9034166431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1059976 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.