Provider Demographics
NPI:1982743209
Name:PRESTON, JESSICA ASHLEY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ASHLEY
Last Name:PRESTON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5661 MUNGER RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9032
Mailing Address - Country:US
Mailing Address - Phone:734-434-8657
Mailing Address - Fax:313-278-4821
Practice Address - Street 1:2100 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2923
Practice Address - Country:US
Practice Address - Phone:313-278-3900
Practice Address - Fax:313-278-4821
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-23
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Provider Licenses
StateLicense IDTaxonomies
MI5601003868363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical