Individual
JESSICA LEIGH BURSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4 CORPORATE DR, SUITE # 484, SHELTON, CT 06484-6211
(203) 944-9898
Mailing address
15 DEERWOOD RD, OXFORD, CT 06478-3209
(203) 305-6977
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2316
CT
363AM0700X
Medical Physician Assistant
002316
CT
Other
Enumeration date
10/04/2009
Last updated
11/12/2021
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