Provider Demographics
NPI:1194061812
Name:PLOWMAN, JESSIKA (CRNA)
Entity type:Individual
Prefix:
First Name:JESSIKA
Middle Name:
Last Name:PLOWMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 LAWNDALE ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1789
Mailing Address - Country:US
Mailing Address - Phone:214-456-6393
Mailing Address - Fax:214-456-7232
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-6393
Practice Address - Fax:214-456-7232
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX829033367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered