Provider Demographics
NPI:1396285680
Name:THURN, JESSICA JEAN (AG-ACNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JEAN
Last Name:THURN
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:JEAN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:201 I ST NE
Mailing Address - Street 2:APT. 408
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4449
Mailing Address - Country:US
Mailing Address - Phone:773-837-1281
Mailing Address - Fax:
Practice Address - Street 1:201 I ST NE
Practice Address - Street 2:APT. 408
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4449
Practice Address - Country:US
Practice Address - Phone:773-837-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1030295363LA2100X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine