| NPI | 1861843278 |
|---|---|
| Former Name | JESSICA LAUREN JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3765) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8007) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2019-01-09 |