Individual
MRS. JESSICA JUNE CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2601 KENTUCKY AVE, SUITE 301, PADUCAH, KY 42003
(270) 575-3113
(270) 575-3135
Mailing address
2605 KENTUCKY AVE, SUITE 306, PADUCAH, KY 42003-3800
(270) 415-7653
(270) 575-8359
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
PA1602
KY
363AM0700X
Medical Physician Assistant
PA1602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100160260
—
KY
Enumeration date
09/30/2010
Last updated
07/25/2024
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