Individual
JESSICA A PREWITT-EMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
575 SIOUX POINT ROAD, DAKOTA DUNES, SD 57049
(605) 217-2667
(605) 217-2900
Mailing address
575 SIOUX POINT ROAD, DAKOTA DUNES, SD 57049
(605) 217-2667
(605) 217-2900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
001882
IA
363AS0400X
Surgical Physician Assistant
Primary
0983
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19960
AVERA HEALTH PLANS
—
01
—
255313
MIDLANDS CHOICE
—
01
—
71758
BCBS IA
IA
01
—
P00605701
RAILROAD MEDICARE
IA
Enumeration date
11/01/2006
Last updated
08/19/2015
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