Individual
DR. JESSILYN RANAE HUMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2711 S ROUSE ST STE B, PITTSBURG, KS 66762-6621
(620) 235-7612
(620) 235-7613
Mailing address
2711 S ROUSE ST STE B, PITTSBURG, KS 66762-6621
(620) 235-7612
(620) 235-7613
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-38113
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201118970A
—
KS
Enumeration date
05/31/2012
Last updated
06/18/2019
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