Search › Texas › 363LA2100X
Jessica Modisette, APRN
NPI 1386393213 · on the registry since 2022 · sole proprietor
Practice
- Address
- 707 E Marshall Ave
Longview, TX 75601 - Phone
- (903) 315-5400
- Organisation at this address
- Medical Plaza Pharmacy
Medical Plaza PharmacyInferred from a shared address, not stated in the registry. - Clinicians at this address
- 10
Additional practice sites
- 700 E Marshall Ave, Longview, TX
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Also registered as
- 163W00000X
363L00000X - Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-05-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas