Individual
MS. JESSICA ANN DELUISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
938 OLD YORK RD, ABINGTON, PA 19001-4703
(267) 620-0237
Mailing address
5000 COX RD APT 620, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054781
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA054781
PENNSYLVANIA STATE LICENSE
PA
Enumeration date
01/28/2011
Last updated
03/28/2018
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