Individual
JESSICA LYN MENARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4132
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700604110A
—
GA
Enumeration date
06/01/2006
Last updated
01/13/2022
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