Provider Demographics
NPI:1932677473
Name:HOWIE, JESSICA (PA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:HOWIE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:PANAMENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 ANDOVER ST FL 1
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4888
Mailing Address - Country:US
Mailing Address - Phone:978-475-9230
Mailing Address - Fax:978-475-9231
Practice Address - Street 1:28 ANDOVER ST FL 1
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810
Practice Address - Country:US
Practice Address - Phone:978-475-9230
Practice Address - Fax:978-475-9231
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6807363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1148309OtherNCCPA
MAPA6807OtherPA LICENSE