NPI 1922404888 · live from the CMS NPI Registry
Jessica Jenae Acosta-Van Den Berg, APRN-CNP
Nurse Practitioner, Family in Clinton, OK. National Provider Identifier 1922404888, active.
NPI record
| NPI | 1922404888 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 10321 N 2274 Rd, Clinton, OK 73601 |
| Practice phone | 580-331-3300 |
| Enumerated | November 5, 2014 |
| Last updated | November 5, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | 96005 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.