Provider Demographics
NPI:1164087466
Name:SCHULTE, JESSICA LEE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEE
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4490 FREMONT PIKE
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9260
Mailing Address - Country:US
Mailing Address - Phone:419-266-4274
Mailing Address - Fax:
Practice Address - Street 1:1110 WEST MAIN CROSS ST.
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-2423
Practice Address - Country:US
Practice Address - Phone:419-423-5492
Practice Address - Fax:419-424-3424
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005940RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11611635OtherNCCPA
OH50.005940RXOtherSTATE MEDICAL BOARD OF OHIO