JEFFREY JESSADA LERTDILOK FNP-C NPI 1720621071

NPI Information

NPI: 1720621071
Provider Name: JEFFREY JESSADA LERTDILOK, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4100 FAIRWAY DR STE 320
CARROLLTON, TX
ZIP 75010
Phone: (972) 236-7608
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Jeffrey Jessada Lertdilok, FNP-C is a family nurse practitioner in Carrollton, TX with 5 years of experience. Jeffrey Jessada Lertdilok, FNP-C NPI is 1720621071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4100 FAIRWAY DR STE 320
CARROLLTON, TX
ZIP 75010-537
Phone: (972) 236-7608

The NPI 1720621071 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/18/2019 and was last updated on 10/18/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP142915	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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