Provider Demographics
NPI:1255927976
Name:ROWE, JESSECCA LYNN (RN)
Entity type:Individual
Prefix:
First Name:JESSECCA
Middle Name:LYNN
Last Name:ROWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JESSECCA
Other - Middle Name:LYNN
Other - Last Name:GORDILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:8815 VIRGINIA RYE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2080
Mailing Address - Country:US
Mailing Address - Phone:702-857-9399
Mailing Address - Fax:
Practice Address - Street 1:1125 TOWHEE TRL
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-3442
Practice Address - Country:US
Practice Address - Phone:737-279-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1157976363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health