Provider Demographics
NPI:1356550081
Name:LOEROP, JESSICA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:LOEROP
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14182 FALL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-8623
Mailing Address - Country:US
Mailing Address - Phone:239-775-5558
Mailing Address - Fax:
Practice Address - Street 1:3301 TAMIAMI TRL E
Practice Address - Street 2:COLLIER GOV'T CENTER - BLDG H
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3969
Practice Address - Country:US
Practice Address - Phone:239-732-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA 9102666363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant