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Individual
JACQUELINE BRITTANY AMSDELL
Active
Individual
JACQUELINE BRITTANY AMSDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
025830
NY
363A00000X
Physician Assistant
PA08521
TX
363AS0400X
Surgical Physician Assistant
Primary
4620
CT
363AS0400X
Surgical Physician Assistant
PA08521
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335901001
—
TX
05
—
335901004
—
TX
01
—
8745NY
BCBS
TX
Enumeration date
07/26/2013
Last updated
05/05/2021
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