Individual
JESSICA MILLER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1122 LADY ST OFC 266, COLUMBIA, SC 29201-3490
(888) 803-3370
Mailing address
1122 LADY ST OFC 266, COLUMBIA, SC 29201-3490
(888) 803-3370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110009664
VA
363A00000X
Physician Assistant
13578808-1206
UT
363A00000X
Physician Assistant
Primary
2597
SC
363A00000X
Physician Assistant
50.004225
OH
363A00000X
Physician Assistant
MA054783
PA
363A00000X
Physician Assistant
PA66333
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115927
—
OH
Enumeration date
09/09/2011
Last updated
04/21/2026
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