Jesseca Anthony, NURSE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703112763 Issued in MI

Practice address

2688 Peachcrest St
Ypsilanti, MI 48198-3323

Phone

(734) 329-1859

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1982133765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 STACY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881439",
            "telephone_number": "734-329-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2688 PEACHCREST ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983323",
            "telephone_number": "734-329-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "JESSECA",
        "credential": "NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703112763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114014529",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.