Provider Demographics
NPI:1922651546
Name:JEWELL, YASSMIRI (NP)
Entity Type:Individual
Prefix:
First Name:YASSMIRI
Middle Name:
Last Name:JEWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22710 PROFESSIONAL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6009
Mailing Address - Country:US
Mailing Address - Phone:281-296-8788
Mailing Address - Fax:
Practice Address - Street 1:1111 MEDICAL PLAZA DR STE 250
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3477
Practice Address - Country:US
Practice Address - Phone:281-296-8788
Practice Address - Fax:281-719-5938
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140049363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology