Healthcare Provider Details

I. General information

NPI: 1982262671
Provider Name (Legal Business Name): JESSICA MICHELLE CURRY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E 30TH AVE
HUTCHINSON KS
67502-1242
US

IV. Provider business mailing address

3411 E SPILLMAN RD
NEW CAMBRIA KS
67470-8551
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-8484
  • Fax:
Mailing address:
  • Phone: 620-218-5652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1502240
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: