Provider Demographics
NPI:1417497611
Name:KUMAR, JESSICA JACKSON (MS, CGC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JACKSON
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12674 ARROWLEAF LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6848
Mailing Address - Country:US
Mailing Address - Phone:812-620-6186
Mailing Address - Fax:
Practice Address - Street 1:4500 SAN PABLO RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-953-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS