Provider Demographics
NPI:1437175536
Name:DUNN, JESSICA MARIE (PA)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:MARIE
Last Name:DUNN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2415
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-2415
Mailing Address - Country:US
Mailing Address - Phone:410-749-4154
Mailing Address - Fax:410-860-9583
Practice Address - Street 1:1675 WOODBROOKE DRIVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-749-4154
Practice Address - Fax:410-860-9583
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPA61209363A00000X
DEC5-0000690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant