MEDICARE: MS. VICTORIA ANN JARRETT 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
1	363AS0400X	Surgical Physician Assistant	006217	GA
2	363A00000X	Physician Assistant	PA9107686	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MD320	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497707145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA ANN JARRETT PA-C

Provider Business Mailing Address
First Line	:	268 LILLY BELL LN
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439-7623
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4545
Country	:	US
Telephone Number	:	850-691-4188
Fax Number	:	833-687-1541

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	09/26/2022

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