Provider Demographics
NPI:1972236966
Name:WETSEL, JESSICA RAE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:WETSEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2547
Mailing Address - Country:US
Mailing Address - Phone:940-691-0985
Mailing Address - Fax:
Practice Address - Street 1:4909 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2547
Practice Address - Country:US
Practice Address - Phone:940-691-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1084569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily