Individual provider · Type 1 NPI

Jessica Nussbaum, PA-C

Medical Physician Assistant · Maryville, IL

NPI number 1184306524 Active

Practice location

6812 State Route 162 Ste 120
Maryville, IL 62062-8586

Call (618) 288-0044 Map

Mailing address

8333 Goshen Rd
Edwardsville, IL 62025-6908

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X085.009880 (IL)

Medical Physician Assistant: Definition to come...

4 other providers at this address

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About NPI 1184306524

Jessica Nussbaum, PA-C's National Provider Identifier is 1184306524, issued on Aug 4, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Maryville, IL. The record was last updated on Aug 4, 2023.