Provider Demographics
NPI:1336495142
Name:HARPER, JESSICA M (PA-C, IBCLC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:HARPER
Suffix:
Gender:F
Credentials:PA-C, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 PROVIDENCE DR # A500
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4691
Mailing Address - Country:US
Mailing Address - Phone:907-562-2423
Mailing Address - Fax:
Practice Address - Street 1:3340 PROVIDENCE DR # A500
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4691
Practice Address - Country:US
Practice Address - Phone:907-562-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK11169577174N00000X
AK169952363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No174N00000XOther Service ProvidersLactation Consultant, Non-RN