Provider Demographics
NPI:1255051942
Name:JARRETT, CAYLEE DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:CAYLEE
Middle Name:DAWN
Last Name:JARRETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:IL
Mailing Address - Zip Code:62286-0378
Mailing Address - Country:US
Mailing Address - Phone:618-443-6821
Mailing Address - Fax:618-443-1382
Practice Address - Street 1:1300 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:IL
Practice Address - Zip Code:62286-1048
Practice Address - Country:US
Practice Address - Phone:618-443-4138
Practice Address - Fax:618-443-3327
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant