Jessica Ballesteros-Holmes, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Bristow, VA
NPI 1972257525 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1972257525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- BALL-37H6G (NC)
- Practice address
- 10492 Bristow Center Dr
Bristow, VA 20136-2202 - Phone
- (571) 379-4246
- NPI assigned
- Feb 11, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BALL-37H6G | NC | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bristow Pediatrics | Past |
Accepting new patients | |
| Trusted Doctors LLC | Past | Accepting new patients |
Interoperability endpoints
- jessica.ballesteros@bp1.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | BALL-37H6G | NC | Yes |
Addresses
Primary practice location
10492 Bristow Center Dr
Bristow, VA 20136-2202
Mailing address
3011 Williams Station Rd
Matthews, NC 28105-1233
Other providers in Bristow, VA
- Apex DME Billing LLC
- Meseret Asfaw
- Associates in Eyecare Bristow PC
- Awareness Lounge Counseling, LLC
- Back 2 Back Chiropractic
- Laura Barrett
- Laura Beth Barrett
- Mabel Bashorun
- Natalia Becker
- Elizabeth Michelle Bender
All providers in Bristow, VA · Pediatric Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. 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.