Individual
DR. JESSICA LYNN MASSARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2059
(313) 745-8040
Mailing address
1466 SHANKIN CT, WOLVERINE LAKE, MI 48390-2436
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704304771
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704304331
MI
Other
Enumeration date
07/29/2022
Last updated
02/07/2025
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