MRS. JESSICA BROOKE SAMPLE (NPI# 1093950115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093950115 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA BROOKE SAMPLE |
| Credential | RN, CPNP-PC |
| Practice Address |
7777 Forest Ln Ste B246 Dallas TX 75230-6816 |
| Mailing Address |
7777 Forest Ln Ste B Dallas TX 75230-2571 |
| Practice Telephone | 9724545288 |
| Mailing Telephone | 9725667730 |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
689425 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1935 Medical District Dr, Dallas, TX 752357701 | 2144562788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932758869 | Jessica Briana Sample | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2019-09-04 |
| Street Address |
7777 FOREST LN STE B246 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-6816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154322162 | Tejas K Shah | Pediatrics | 7777 Forest Ln Ste B246, Dallas, TX 75230-6816 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598229510 | Sara Klueber | Nurse Practitioner | 1935 Medical District Dr # C8.01, Dallas, TX 75235-7701 | 2019-01-23 |
| 1932671443 | Allison Blazek | Nurse Practitioner | 1935 Medical District Dr # F3.214, Dallas, TX 75235-7701 | 2018-12-21 |
| 1124520291 | Dalia K George | Nurse Practitioner | 7777 Forest Ln Ste C840, Dallas, TX 75230-2594 | 2018-03-06 |
| 1740790849 | Madeline Claire Crank | Nurse Practitioner | 7777 Forest Ln Ste C742, Dallas, TX 75230-6862 | 2017-10-03 |
| 1215480355 | Ashley Smith | Nurse Practitioner | 8325 Walnut Hill Ln# 225, Dallas, TX 75231 | 2016-07-25 |
| 1316349962 | Jennifer Tracy | Nurse Practitioner | 2350 N Stemmons Fwy Ste 4300mcf4, Dallas, TX 75207-2700 | 2014-09-25 |
| 1013334879 | Sneha Patel | Nurse Practitioner | 4830 Cedar Springs Rd, Unit 3, Dallas, TX 75219-1366 | 2014-03-18 |
| 1720415748 | Heidi Nicole Pettit | Nurse Practitioner | 1935 Medical District Dr # E2300, Dallas, TX 75235-7701 | 2013-10-04 |
| 1821357088 | Robyn Joy Haynes | Nurse Practitioner | 1935 Medical District Dr # D2.04, Dallas, TX 75235-7701 | 2012-05-09 |
| 1205102589 | Ashley Caroline Eckstein | Nurse Practitioner | 8440 Walnut Hill Ln Ste 540, Dallas, TX 75231-3824 | 2012-03-30 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.