Provider Demographics
NPI:1134225394
Name:DUPUIS, JESSICA L (MPAS PAC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:DUPUIS
Suffix:
Gender:F
Credentials:MPAS PAC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:POSTOIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 ENDICOTT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3623
Mailing Address - Country:US
Mailing Address - Phone:978-745-6601
Mailing Address - Fax:978-624-4040
Practice Address - Street 1:104 ENDICOTT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3623
Practice Address - Country:US
Practice Address - Phone:978-745-6601
Practice Address - Fax:978-624-4040
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2153363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant