Provider Demographics
NPI:1184262834
Name:HARRINGTON, JESSICA (APN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:ALTHOF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:208 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-2706
Mailing Address - Country:US
Mailing Address - Phone:210-383-4601
Mailing Address - Fax:
Practice Address - Street 1:1104 6TH ST
Practice Address - Street 2:
Practice Address - City:RYAN
Practice Address - State:OK
Practice Address - Zip Code:73565-9549
Practice Address - Country:US
Practice Address - Phone:580-757-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141158363LF0000X
OK211404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily