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NPI Code Detail

MEDICARE: JESSICA MARIE THURMAN PA-C

MEDICARE: JESSICA MARIE THURMAN PA-C
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
1363A00000XPhysician Assistant0804SD
2363A00000XPhysician Assistant077003IA

General Provider Information

NPI Number : 1235401852
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE THURMAN PA-C
Provider Business Mailing Address
First Line : 4500 N LEWIS AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-7111
Country : US
Telephone Number : 605-322-4236
Fax Number : 605-322-2097
Provider Business Practice Location Address
First Line : 4500 N LEWIS AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-7111
Country : US
Telephone Number : 605-322-4236
Fax Number : 605-322-2097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2012
Last Update Date : 05/28/2015

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Directions to “ JESSICA MARIE THURMAN PA-C” Practice Location

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