Provider Demographics
NPI:1497111496
Name:SERRANO, JESSICA CAITLYN (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CAITLYN
Last Name:SERRANO
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 N GRAND PKWY W STE 400
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-1685
Mailing Address - Country:US
Mailing Address - Phone:322-601-7868
Mailing Address - Fax:281-377-5767
Practice Address - Street 1:7202 N GRAND PKWY W STE 400
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-1685
Practice Address - Country:US
Practice Address - Phone:281-377-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129908363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health