Individual
JESSICA ANNE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1720A MEDICAL PARK DR STE 150, BILOXI, MS 39532-2135
(228) 392-7429
(228) 396-3830
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00390
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006231797
—
MS
Enumeration date
10/27/2006
Last updated
11/28/2023
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