Provider Demographics
NPI:1306422506
Name:SHUELL, JESSICA NICHOLE (DNP FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICHOLE
Last Name:SHUELL
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 NE OAKBROOK CIR APT G
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-7661
Mailing Address - Country:US
Mailing Address - Phone:360-991-4879
Mailing Address - Fax:
Practice Address - Street 1:8716 E MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2531
Practice Address - Country:US
Practice Address - Phone:360-514-4325
Practice Address - Fax:360-514-4336
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61088225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily