Jessica Brough
Physician Assistant, Surgical in Springfield, IL. Individual provider (NPI-1).
NPI number1356961908
StatusActive
Last updated in NPPESMay 1, 2023
Details
- NPI
- 1356961908
- Entity type
- Individual (NPI-1)
- Name
- Jessica Brough
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 23, 2020
- Certification date
- May 1, 2023
- Last updated
- May 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 085008034 | IL | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
800 N 1st StSpringfield, IL 62702-3778
Phone 217-528-7541
Mailing address
Po Box 19248Springfield, IL 62794-9248
Phone 217-528-7541
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Other Surgical Physician Assistant providers in Springfield, IL
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All 13 Surgical Physician Assistant providers in Springfield · All 5,952 providers in Springfield
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