Individual
JESSICA DIANE TROSPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 SALMON CREEK LANE, JUNEAU, AK 99801-7809
(907) 463-4040
Mailing address
3100 CHANNEL DR STE 300, JUNEAU, AK 99801-7837
(907) 463-4074
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363A00000X
Physician Assistant
Primary
PA3575
TN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171614
OCCUPATIONAL LICENSE
AK
Enumeration date
12/11/2013
Last updated
05/28/2021
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