Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP60037772 | WA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | NP95012326 | CA |
NPI | 1013196310 |
---|---|
Provider Name | Jessica Jeanne Mcelhose |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2007 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00043791-00 | (05) | FL |
003118865A | (05) | GA |
8949510 | LABOR & INDUSTRIES CRIME VICTIMS (01) | WA |
9659434 | (05) | WA |