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1508549742
JESSICA YVONNE SALAKSANA
BRENTWOOD, TN
NPI
1508549742
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209028021)
Enumeration Date
2023-08-14
Last Update Date
2023-10-13
Business Address
Ms. JESSICA YVONNE SALAKSANA APRN
214 CENTERVIEW DR
BRENTWOOD, TN 37027-5274
Phone number: 913-222-8425
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Mailing Address
Ms. JESSICA YVONNE SALAKSANA APRN
565 LAKEVIEW PKWY STE 104
VERNON HILLS, IL 60061-1822
Phone number: 224-998-5450
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