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General NPI Number Information
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NPI Number | 1053997296
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Entity Type | Individual
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Provider Name | JESSICA FIELDS LPTA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 955 HARPERSVILLE RD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1085
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Country | US
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Telephone | 757-223-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 789 TODDS LN
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City | HAMPTON
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State | VA
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Zip | 23666-1825
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Country | US
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Telephone | 757-897-1409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306605629
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License Number State | VA
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