Individual provider · Type 1 NPI

Jessica Mae Moody, PHYSICIAN ASSISTANT

Medical Physician Assistant · Phoenix, AZ

NPI number 1043349400 Active

Practice location

11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039

Call (480) 900-3556 Map

Mailing address

28727 N 20th Ave
Phoenix, AZ 85085-0727

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X3474 (AZ)
Medical Physician Assistant Primary 363AM0700X3474 (AZ)

Medical Physician Assistant: Definition to come...

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About NPI 1043349400

Jessica Mae Moody, PHYSICIAN ASSISTANT's National Provider Identifier is 1043349400, issued on Mar 3, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Phoenix, AZ. The record was last updated on Mar 31, 2023.