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General NPI Number Information
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NPI Number | 1144595026
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Entity Type | Individual
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Provider Name | JESSICA JEAN DEARMAN PA
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Gender | Female
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 400 S RUFFNER RD
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City | CHARLESTON
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State | WV
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Zip | 25314-1542
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Country | US
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Telephone | 304-720-9595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5275
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City | VIENNA
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State | WV
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Zip | 26105-5275
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 01615
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License Number State | WV
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