Provider Demographics
NPI:1437677234
Name:WESMILLER, JESSICA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:WESMILLER
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:ST. JOSEPH'S/ CANDLER- MANAGED CARE DEPT
Mailing Address - Street 2:836 E 65TH STREET, STE 22
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-0001
Mailing Address - Country:US
Mailing Address - Phone:128-192-6229
Mailing Address - Fax:
Practice Address - Street 1:5356 REYNOLDS ST STE 505
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6017
Practice Address - Country:US
Practice Address - Phone:912-356-1515
Practice Address - Fax:912-644-0755
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10530363A00000X
NH1307363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10530OtherSTATE MEDICAL BOARD