Provider Demographics
NPI:1639759335
Name:PERLEY, JESSICA R (ARNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:PERLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E HERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1359
Mailing Address - Country:US
Mailing Address - Phone:541-326-4777
Mailing Address - Fax:541-708-6372
Practice Address - Street 1:148 E HERSEY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1359
Practice Address - Country:US
Practice Address - Phone:541-326-4777
Practice Address - Fax:541-708-6372
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5380079081363LP2300X
OR202200981NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care