Tacconelli, Jessica Marie

Tacconelli, Jessica Marie is an individual health care provider with primary practice located at 6330 Orchard Lake Rd. Suite 120, West Bloomfield MI 48322. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Tacconelli, Jessica Marie can be contacted via phone (248) 855-3366.

Contact Information

Primary practice address
6330 Orchard Lake Rd. Suite 120 West Bloomfield MI 48322
Phone: (248) 855-3366
Fax: (248) 855-6213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601006221 Michigan

Profile Details

NPI number 1164791752
LBN Legal business name Tacconelli, Jessica Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2011
Last updated Dec 28th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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