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Individual

JESSICA R HESFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2123 AUBURN AVE STE 334, CINCINNATI, OH 45219-2906
(513) 585-1500
(513) 585-1510
Mailing address
237 WILLIAM HOWARD TAFT RD, CBO2-3, ATTN - CREDENTIALING, CINCINNATI, OH 45219
(513) 263-8571
(513) 263-8622

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004691
OH
363AM0700X
Medical Physician Assistant
085004942
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100523340
KY
Enumeration date
12/04/2013
Last updated
02/05/2020
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