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NPI Code Detail

MEDICARE: JESSICA MICHAELS

MEDICARE: JESSICA MICHAELS
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 Assistant0110011665VA

General Provider Information

NPI Number : 1689484214
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MICHAELS
Provider Business Mailing Address
First Line : 7130 GLEN FOREST DR STE 101
Second Line :
City : RICHMOND
State : VA
Zip : 23226-3754
Country : US
Telephone Number : 804-288-4084
Fax Number : 804-282-2601
Provider Business Practice Location Address
First Line : 12129 GRAHAM MEADOWS DR
Second Line :
City : RICHMOND
State : VA
Zip : 23233-6661
Country : US
Telephone Number : 804-288-4084
Fax Number : 804-282-2601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 04/14/2026

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Directions to “ JESSICA MICHAELS ” Practice Location

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