Provider Demographics
NPI:1720791023
Name:ALFA, OJOCHIDE JESSICA (NP)
Entity Type:Individual
Prefix:
First Name:OJOCHIDE
Middle Name:JESSICA
Last Name:ALFA
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 1:117 TUCANA ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2217
Mailing Address - Country:US
Mailing Address - Phone:512-541-6438
Mailing Address - Fax:
Practice Address - Street 1:117 TUCANA ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2217
Practice Address - Country:US
Practice Address - Phone:512-541-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1105203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily