Individual provider · Type 1 NPI

Jessica M. Vanderham, CNP

Family Nurse Practitioner · Wagner, SD

NPI number 1285143891 Active

Practice location

513 3rd St SW
Wagner, SD 57380-9675

Mailing address

6915 Village Medical Cir
Clemmons, NC 27012-8002

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XCP001277 (SD)
Family Nurse Practitioner Primary 363LF0000X5017905 (NC)

Family Nurse Practitioner: Definition to come...

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About NPI 1285143891

Jessica M. Vanderham, CNP's National Provider Identifier is 1285143891, issued on Sep 26, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Wagner, SD. The record was last updated on Apr 16, 2024.