Provider Demographics
NPI:1760954572
Name:PERINI, JESSICA LYN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYN
Last Name:PERINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 ANTILLEY RD STE 260
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5249
Mailing Address - Country:US
Mailing Address - Phone:325-793-5211
Mailing Address - Fax:325-793-5212
Practice Address - Street 1:1665 ANTILLEY RD STE 260
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5249
Practice Address - Country:US
Practice Address - Phone:325-793-5211
Practice Address - Fax:325-793-5212
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily