Provider Demographics
NPI:1821754631
Name:THURMAN, JESSALYNN DENTON (FNP)
Entity Type:Individual
Prefix:
First Name:JESSALYNN
Middle Name:DENTON
Last Name:THURMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 TED CIR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-9528
Mailing Address - Country:US
Mailing Address - Phone:601-832-8731
Mailing Address - Fax:
Practice Address - Street 1:110 S PEARSON RD
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-5635
Practice Address - Country:US
Practice Address - Phone:601-968-1237
Practice Address - Fax:601-968-1246
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily