Individual
MRS. JESSICA SACHELLE BYRDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1441 N 12TH ST FL 2, PHOENIX, AZ 85006-2837
(602) 521-5180
Mailing address
1441 N 12TH ST FL 2, PHOENIX, AZ 85006-2837
(602) 570-6618
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5012
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881970689
NPI
AZ
01
—
5012
LICENSE
AZ
Enumeration date
10/25/2011
Last updated
03/07/2023
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