Individual provider · Type 1 NPI
Jessie Wackerman
Acute Care Nurse Practitioner · Corona, CA
NPI number
1053085076
Active
Practice location
4101 Mount Cantara Cir
Corona, CA 92882-7942
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 95017895 (CA) |
| Gerontology Nurse Practitioner | 363LG0600X | 95017895 (CA) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | 95017895 (CA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1053085076
Jessie Wackerman's National Provider Identifier is 1053085076, issued on Aug 3, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Corona, CA. The record was last updated on Aug 3, 2021.