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Individual
JESSICA ROSE MAYER
Active
Individual
JESSICA ROSE MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS015901
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2680246
BLUE SHIELD
PA
01
—
3856419
COVENTRY
PA
01
—
3871997000
IBC/KHPE
PA
Enumeration date
10/06/2008
Last updated
08/19/2024
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