Provider Demographics
NPI:1053666198
Name:BURNS, JESSICA ABBATE (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ABBATE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 HARROUN RD STE 160
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2174
Mailing Address - Country:US
Mailing Address - Phone:419-824-5668
Mailing Address - Fax:419-885-3919
Practice Address - Street 1:5308 HARROUN RD STE 160
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2174
Practice Address - Country:US
Practice Address - Phone:419-824-5668
Practice Address - Fax:419-885-6919
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301101487207V00000X
OH35137362207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology