Jessica Nicole Devoogd, PA-C
Physician Assistant in Southfield, MI. Individual provider (NPI-1).
NPI number1982148060
StatusActive
Last updated in NPPESDec 8, 2016
Details
- NPI
- 1982148060
- Entity type
- Individual (NPI-1)
- Name
- Jessica Nicole Devoogd
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 8, 2016
- Last updated
- Dec 8, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5601007998 | MI | Yes |
Practice location
16001 W 9 Mile RdSouthfield, MI 48075-4818
Phone 248-778-6644
Mailing address
Po Box 100Royal Oak, MI 48068-0100
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