| Doctor Name: | JESSICA LEE MACKERT |
| NPI Number: | 1093062515 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 735503 |
| Business Practice Address: | 15803 Windermere Dr Suite 103 Pflugerville, TX - 786602402 |
| Business Phone Number: | 5129892680 |
| Business Fax Number: | 5124067339 |
| Mailing Address: | 4515 Seton Center Pkwy, Suite 215 - Credentialing AUSTIN |
| State: | TX |
| Postal Code: | 787595290 |
| Phone Number: | 5124078686 |
| Fax Number: | 5124066216 |
| NPI Enumeration Date: | 08/14/2012 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 735503 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |