Provider Demographics
NPI:1932648318
Name:HESS, JENNIFER JEAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:HESS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JEAN
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4653
Mailing Address - Country:US
Mailing Address - Phone:217-238-6055
Mailing Address - Fax:217-258-2216
Practice Address - Street 1:1303 W EVERGREEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1638
Practice Address - Country:US
Practice Address - Phone:217-342-3400
Practice Address - Fax:217-342-3477
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015372363L00000X
IL209015372363LX0106X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health