Provider Demographics
NPI:1629378831
Name:FIELDS, JESSICA J (PA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:J
Last Name:FIELDS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 48089
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-8089
Mailing Address - Country:US
Mailing Address - Phone:706-389-3740
Mailing Address - Fax:706-389-3951
Practice Address - Street 1:1500 OGLETHORPE AVE STE 2000
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2188
Practice Address - Country:US
Practice Address - Phone:706-548-5488
Practice Address - Fax:706-548-0016
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA5953363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant