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Individual
MS. KELLY CHRISTINE JEW-GARCIA
Active
Individual
MS. KELLY CHRISTINE JEW-GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010584
MI
363A00000X
Physician Assistant
PA57791
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315227043
MICHIGAN TASK FORCE CONTROLLED SUBSTANCE LICENSE
MI
01
—
5601010584
MICHIGAN TASK FORCE ON PHYSICIANS ASSISTANTS
MI
01
—
PA57791
PA BOARD OF CALIFORNIA
CA
Enumeration date
02/24/2020
Last updated
07/21/2022
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