Individual
JAMIE LYNN WHITESELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2208 SPROUL RD, BROOMALL, PA 19008-2252
(610) 888-9446
Mailing address
2208 SPROUL RD, BROOMALL, PA 19008-2252
(610) 888-9446
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060058
PA
363A00000X
Physician Assistant
OA004590
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/17/2016
Last updated
08/02/2023
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