Provider Demographics
NPI:1124782537
Name:PRICE, JESSICA (FNP-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PRICE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:METLAKATLA
Mailing Address - State:AK
Mailing Address - Zip Code:99926-0013
Mailing Address - Country:US
Mailing Address - Phone:907-886-2088
Mailing Address - Fax:
Practice Address - Street 1:563 BRENDIBLE STREET
Practice Address - Street 2:
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926-0013
Practice Address - Country:US
Practice Address - Phone:907-886-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057392363LF0000X
AK230682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily