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Individual

JESSICA KELLY SIMMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
19415 DEERFIELD AVE STE 314, LEESBURG, VA 20176-8472
(703) 723-7171
(703) 723-7176
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-3346
(703) 737-6010
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110006087
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110006087
VIRGINIA LICENSE
VA
05
1376044164
VA
05
30016148880002
VA
Enumeration date
02/27/2018
Last updated
03/07/2024
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