Individual
JESSICA KENT ERIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19450 DEERFIELD AVENUE, SUITE 300, LEESBURG, VA 20176-2681
(703) 858-3220
(703) 858-3221
Mailing address
224-D CORNWALL ST. NW SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008446
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093479339
—
VA
05
—
30017438600001
—
VA
Enumeration date
10/22/2021
Last updated
03/06/2024
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