Provider Demographics
NPI:1235478553
Name:ANDERSON, JESSICA H (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:H
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 PIPER ST STE S410
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4673
Mailing Address - Country:US
Mailing Address - Phone:907-561-1436
Mailing Address - Fax:
Practice Address - Street 1:3831 PIPER ST STE S410
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4673
Practice Address - Country:US
Practice Address - Phone:907-561-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant