Provider Demographics
NPI:1437743051
Name:HEINSEN, JESSICA (PT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:HEINSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:SCHEPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:146 ROARING SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-1751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2035 FORT WORTH HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4783
Practice Address - Country:US
Practice Address - Phone:817-912-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1329265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist