Provider Demographics
NPI:1104641810
Name:WEST, JESSICA ELAINE (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELAINE
Last Name:WEST
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2725
Mailing Address - Country:US
Mailing Address - Phone:832-282-9779
Mailing Address - Fax:
Practice Address - Street 1:16100 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1895
Practice Address - Country:US
Practice Address - Phone:713-413-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179855363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine