Individual
JESSICA SHAHDA
Active
Individual
JESSICA SHAHDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2366832
MA
363LG0600X
Gerontology Nurse Practitioner
71005654A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201315670
—
IN
01
—
P01588254
MEDICARE RAILROAD PTAN
IN
Enumeration date
08/31/2015
Last updated
02/21/2023
Update your record
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