MEDICARE: JESSICA O'BRIEN P.A.-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	363A00000X	Physician Assistant	7734	AZ
2	363A00000X	Physician Assistant	0010-12772	NC
3	363A00000X	Physician Assistant	C0008241	MD
4	363A00000X	Physician Assistant	PA031097	DC
5	363A00000X	Physician Assistant	PA52917	CA
6	363A00000X	Physician Assistant	PA3404	SC
7	363A00000X	Physician Assistant	0110-008469	VA
8	363A00000X	Physician Assistant	2022042041	MO

General Provider Information

NPI Number	:	1902204340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA O'BRIEN P.A.-C.

Provider Business Mailing Address
First Line	:	5100 EASTERN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-2772
Country	:	US
Telephone Number	:	410-814-4500
Fax Number	:	410-400-8600

Provider Business Practice Location Address
First Line	:	5100 EASTERN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-2772
Country	:	US
Telephone Number	:	410-814-4500
Fax Number	:

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

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	12/08/2025

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Directions to “ JESSICA O'BRIEN P.A.-C.” Practice Location

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