Individual
MRS. ELISHA MARIE JAYARAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65201-5276
(573) 882-4909
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-4909
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
2011017515
MO
363AS0400X
Surgical Physician Assistant
Primary
AP2174
MA
Other
Enumeration date
04/30/2009
Last updated
12/29/2011
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