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Individual
JESSICA A LUNDGREN
Active
Individual
JESSICA A LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
0101264541
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD474581
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101264541
MEDICAL LICENSE
VA
01
—
MD474581
MEDICAL LICENSE
PA
Enumeration date
03/25/2012
Last updated
08/06/2022
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