Healthcare Provider Details

I. General information

NPI: 1629384193
Provider Name (Legal Business Name): JESSICA J PECKINPAUGH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA A JOCHIM PA-C

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CROSSLAKE DR
EVANSVILLE IN
47715-8198
US

IV. Provider business mailing address

250 W 96TH ST STE 520
INDIANAPOLIS IN
46260-1317
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-6694
  • Fax:
Mailing address:
  • Phone: 317-583-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001242A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: