Provider Demographics
NPI:1649638230
Name:MIDENCE, JESSICA (DVM)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:MIDENCE
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 CABOT BLVD W STE D
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2451
Mailing Address - Country:US
Mailing Address - Phone:215-750-2774
Mailing Address - Fax:
Practice Address - Street 1:2010 CABOT BLVD W STE D
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2451
Practice Address - Country:US
Practice Address - Phone:215-750-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABV013904174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian