Healthcare Provider Details

I. General information

NPI: 1457647091
Provider Name (Legal Business Name): JESSICA CHRISTINE GERMINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA CHRISTINE LESTER

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 N WILMOT RD
TUCSON AZ
85711-2701
US

IV. Provider business mailing address

700 E MOREHEAD ST STE 300
CHARLOTTE NC
28202-2742
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-2889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD180785
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: