Doctor Name: | MARTHA JESSOP |
NPI Number: | 1801123534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-FNP, BC |
License Number: | 5855479-4405 |
Business Practice Address: | 8299 Mt Highway 35 Bigfork, MT - 599113583 |
Business Phone Number: | 4068375541 |
Business Fax Number: | |
Mailing Address: | 8299 Mt Highway 35, BIGFORK |
State: | MT |
Postal Code: | 599113583 |
Phone Number: | 4068375541 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2009 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5855479-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |