Jessica Blair, PA
Physician Assistant in Peoria, IL. Individual provider (NPI-1).
NPI number1497267207
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1497267207
- Entity type
- Individual (NPI-1)
- Name
- Jessica Blair
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2017
- Last updated
- Nov 2, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085006423 | IL | Yes |
Practice location
8600 State Route 91 Ste 130Peoria, IL 61615-7829
Phone 309-683-5050 · Fax 309-683-5335
Mailing address
8600 State Route 91 Ste 130Peoria, IL 61615-7829
Phone 309-683-5050 · Fax 309-683-5335
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