Provider Demographics
NPI:1073370730
Name:LE, JESSICA CASIMIRO (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:CASIMIRO
Last Name:LE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 HAWKINS LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6352
Mailing Address - Country:US
Mailing Address - Phone:832-629-3474
Mailing Address - Fax:
Practice Address - Street 1:13440 UNIVERSITY BLVD STE 180
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4908
Practice Address - Country:US
Practice Address - Phone:281-994-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX969109163W00000X
TX1152850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse