Individual
JESSICA LEIGH KERNODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4075 COPPER RIDGE DR, TRAVERSE CITY, MI 49684-7059
(231) 946-8970
(231) 932-4123
Mailing address
10710 MIDLOTHIAN TPKE, STE 200, NORTH CHESTERFIELD, VA 23235-4759
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003487
VA
Other
Enumeration date
02/08/2011
Last updated
10/25/2018
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