Individual
JESSICA SCOVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
804 22ND AVE, KEARNEY, NE 68845-2206
(308) 440-1101
Mailing address
1710 LINCOLN AVE, COZAD, NE 69130-1660
(308) 440-1101
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
40
NE
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
09/13/2018
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