MEDICARE: JESSICA LOUISE PESHA A.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	517	GA
2	171100000X	Acupuncturist	AP2586	FL

General Provider Information

NPI Number	:	1073877734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LOUISE PESHA A.P.

Provider Business Mailing Address
First Line	:	105 TARBERT CUT
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-6379
Country	:	US
Telephone Number	:	912-556-2229
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 FRANCES MEEKS WAY STE 12
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-3984
Country	:	US
Telephone Number	:	912-556-2229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	12/11/2025

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