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General NPI Number Information
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NPI Number | 1508364340
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Entity Type | Individual
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Provider Name | JESSICA FAITH ANDERSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 4715 WHITESBURG DR SE
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1649
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Country | US
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Telephone | 256-881-5151
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Fax | 256-880-3939
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Provider Business Mailing Address
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Address Line | 4715 WHITESBURG DR SE
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1649
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Country | US
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Telephone | 256-881-5151
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Fax | 256-880-3939
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008653
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7697
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.2422
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5284
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License Number State | SC
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