Individual
JESSICA O RAASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3385 DEXTER CT, SUITE 300, DAVENPORT, IA 52807-3471
(563) 344-9292
(563) 344-9573
Mailing address
3385 DEXTER CT, SUITE 300, DAVENPORT, IA 52807-3471
(563) 344-9292
(563) 344-9573
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002060
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213140006
MEDICARE INDIVIDUAL PTAN
IA
01
—
IL2709013
INDIVIDUAL PTAN
IL
Enumeration date
12/28/2009
Last updated
04/20/2017
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