Provider Demographics
NPI:1487632709
Name:ESTES, JESSICA L (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:ESTES
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 FOLKER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5321
Mailing Address - Country:US
Mailing Address - Phone:907-563-1000
Mailing Address - Fax:
Practice Address - Street 1:1210 4TH ST
Practice Address - Street 2:
Practice Address - City:LEWISPORT
Practice Address - State:KY
Practice Address - Zip Code:42351-2526
Practice Address - Country:US
Practice Address - Phone:270-255-4341
Practice Address - Fax:270-255-4767
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002013A363LP0808X
KY3004576363LP0808X
AK167419363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200939340Medicaid
KY7801519500Medicaid
KY7801519500Medicaid
IN200939340Medicaid