Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jelissa Nicole

Organization Prosthetic/Orthotic Supplier · NPI 1639769862

Jelissa Nicole is a Prosthetic/Orthotic Supplier in Dallas, Texas. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

18880 Marsh Ln Apt 1902
Dallas, TX 75287-2241
Phone: (214) 497-8580
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X

Record details

NPI number1639769862
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jelissa Bates — Owner · (214) 497-8580
NPI enumeratedJanuary 21, 2021
Last updated in NPPESJanuary 21, 2021
Certification dateJanuary 21, 2021
Mailing address18880 Marsh Ln Apt 1902, Dallas, TX 75287-2241

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