Provider Demographics
NPI:1972358992
Name:PEARSON, JESSICA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNN
Last Name:PEARSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20806 STATE HIGHWAY 164
Mailing Address - Street 2:
Mailing Address - City:HORNERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63855-9739
Mailing Address - Country:US
Mailing Address - Phone:731-487-5338
Mailing Address - Fax:
Practice Address - Street 1:527 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2407
Practice Address - Country:US
Practice Address - Phone:870-729-1279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program