# JENA SPOSTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538494836
- **Gender:** F
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA07345 | TX | Yes |
| 363AM0700X | Medical Physician Assistant | 013586 | NY | — |
| 363AS0400X | Surgical Physician Assistant | MA054310 | PA | — |
| 363AS0400X | Surgical Physician Assistant | PA07345 | TX | — |

## Other

- **Enumeration date:** 10/05/2009
- **Last updated:** 10/30/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 013586 | LICENSE | NY |
| 01 | — | MA054310 | STATE BOARD OF MEDICINE | PA |
| 01 | — | PA07345 | PHYSICIAN ASSISTANCE LICENSE | TX |