Individual
JESSICA LYNN SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 N LINCOLN ST, GREENSBURG, IN 47240-1398
(812) 663-4331
Mailing address
2512 W STATE ROAD 144, FRANKLIN, IN 46131-8390
(970) 234-5377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003845A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002719
—
OH
Enumeration date
08/29/2022
Last updated
01/16/2024
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