Vanderham, Jessica M

Vanderham, Jessica M is an individual health care provider with primary practice located at 513 3Rd St Sw , Wagner SD 57380-9675. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Vanderham, Jessica M can be contacted via phone (605) 384-3611.

Contact Information

Primary practice address
513 3Rd St Sw Wagner SD 57380-9675
Phone: (605) 384-3611
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CP001277 South Dakota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5017905 North Carolina

Profile Details

NPI number 1285143891
LBN Legal business name Vanderham, Jessica M
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2017
Last updated Apr 16th, 2024 - about last year

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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