Provider Demographics
NPI:1952043028
Name:GANAPATHY, JESSICA SKYLAR (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SKYLAR
Last Name:GANAPATHY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:4219 GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-7925
Mailing Address - Country:US
Mailing Address - Phone:812-842-9545
Mailing Address - Fax:
Practice Address - Street 1:4219 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7925
Practice Address - Country:US
Practice Address - Phone:812-842-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-10-06
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant