Provider Demographics
NPI:1467653790
Name:PULLIAM, JESSICA STRICKLAND (P A)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:STRICKLAND
Last Name:PULLIAM
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
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Mailing Address - Street 1:950 N GLEBE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1824
Mailing Address - Country:US
Mailing Address - Phone:571-366-8850
Mailing Address - Fax:919-456-5393
Practice Address - Street 1:570 NEW WAVERLY PL
Practice Address - Street 2:ST 210
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7405
Practice Address - Country:US
Practice Address - Phone:919-859-3373
Practice Address - Fax:919-859-3122
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9113088363A00000X
NC0010-00910363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010 00910OtherPA-C
FLMD042OtherFL MEDICARE