Provider Demographics
NPI:1851015937
Name:DEARBORN, JESSICA ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:DEARBORN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:HAEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:18347 TIMBER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-4820
Mailing Address - Country:US
Mailing Address - Phone:503-998-3655
Mailing Address - Fax:
Practice Address - Street 1:18347 TIMBER OAKS DR
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-4820
Practice Address - Country:US
Practice Address - Phone:503-998-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator