Provider / Organization | NPI | Date Certified |
---|---|---|
JESSICA DIANE CORDER | 1518547066 | 2021-07-09 |
Jessica Diane Corder is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1518547066. Registration indicates Jessica Diane Corder is a provider of services with a specialization in Other Service Providers, Military Health Care Provider (Military Health Care Provider, ) (Military Health Care Provider, Other Service Providers)
Entity Type | Individual |
Provider Name | Jessica Diane Corder |
Practice Office Address | 620 JOHN PAUL JONES CIR PORTSMOUTH, VA US |
Practice Office Telephone | 7579532339 |
Mailing Address | 554 KEILY STREET JACKSONVILLE, FL 32212 US |
Business Telephone | 7579537550 |
Business Fax | 7579537560 |
Code | Practice | License No State |
---|---|---|
171000000X PRIMARY | Other Service Providers Military Health Care Provider Military Health Care Provider Military Health Care Provider Other Service Providers |