Individual
MS. JESSICA ANN WAATTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4755 OLGLETOWN-STANTON RD, NEWARK, DE 19718-9636
(130) 273-3100
Mailing address
27 MARY JANE LN, ELKTON, MD 21921-3557
(443) 252-1373
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2079317
—
WA
05
—
500717752
—
OR
Enumeration date
09/21/2016
Last updated
05/08/2023
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