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Individual

MRS. JAMILA LEE PETTERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
TRAINEE HEALTH CLINIC, 1940 CARSWELL AVE BLDG. 7002, JBSA LACKLAND,, TX 78236
(210) 471-9056
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
363A00000X
Physician Assistant
Primary
1043226
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/25/2007
Last updated
01/13/2026
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