Individual
JESSICA LYNNE STAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5735 MEEKER RD, GREENVILLE, OH 45331-1186
(937) 548-9680
(937) 548-2087
Mailing address
5735 MEEKER RD, GREENVILLE, OH 45331-1186
(937) 548-3806
(937) 548-2087
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50003341
OH
363AM0700X
Medical Physician Assistant
Primary
50.003341
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081623
—
OH
Enumeration date
10/12/2011
Last updated
11/02/2023
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