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General NPI Number Information
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NPI Number | 1982304895
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Entity Type | Individual
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Provider Name | JESSICA BIRKS PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 800 KENYON RD STE S
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City | FORT DODGE
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State | IA
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Zip | 50501-5776
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Country | US
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Telephone | 515-574-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 BYRON ST
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City | STRATFORD
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State | IA
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Zip | 50249-7756
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Country | US
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Telephone | 712-210-3803
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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 | 127393
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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