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General NPI Number Information
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NPI Number | 1710562111
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Entity Type | Individual
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Provider Name | JESSICA LYNN BARAT PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 7645 MARKET ST STE 210
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City | BOARDMAN
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State | OH
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Zip | 44512-6098
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Country | US
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Telephone | 330-726-3724
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 BARKER BLVD APT A
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City | KENT
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State | OH
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Zip | 44240-8623
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Country | US
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Telephone | 724-496-9522
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.007169RX
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License Number State | OH
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