Jessica Yvette Crockett
Individual provider Active NPI Licensed Vocational Nurse · Jefferson, TX
NPI 1346729464 · NPPES record last updated Aug 9, 2018
Key facts
- NPI
- 1346729464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 186121 (TX)
- Practice address
- 120 N Walnut St
Jefferson, TX 75657-1934 - Phone
- (903) 665-6131
- NPI assigned
- Aug 9, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186121 | TX | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First in Pediatrics Home Health Care, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 186121 | TX | Yes |
Addresses
Primary practice location
120 N Walnut St
Jefferson, TX 75657-1934
Mailing address
PO Box 901
Jefferson, TX 75657-0901
Other providers in Jefferson, TX
- Melissa Loretta Colbert
- Billie Lorraine Coleman
- Haley Michelle Collard
- Core Health Systems
- Ellen Jeanette Coverdell
- Cypress Place Assisted Living
- Cypress Place Re 2015, LLC
- Lisa Marie Daniel
- Brett Andrew Darragh
- Rose Devine Davis
All providers in Jefferson, TX · Licensed Vocational Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.