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1184306524
JESSICA NUSSBAUM
MARYVILLE, IL
NPI
1184306524
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: IL 085.009880)
Enumeration Date
2023-08-04
Last Update Date
2023-08-04
Business Address
JESSICA NUSSBAUM PA-C
6812 STATE ROUTE 162 STE 120
MARYVILLE, IL 62062-8586
Phone number: 618-288-0044
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Mailing Address
JESSICA NUSSBAUM PA-C
8333 GOSHEN RD
EDWARDSVILLE, IL 62025-6908
Phone number: 309-310-7824
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