Vercruysse, Jessica Lise
Vercruysse, Jessica Lise is an individual health care provider with primary practice located at 112 Mansfield Ave , Willimantic CT 06226-2045. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Vercruysse, Jessica Lise can be contacted via phone (904) 265-6850.Contact Information
Primary practice address
112 Mansfield Ave
Willimantic CT 06226-2045
Phone: (904) 265-6850
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 4351045618 | Michigan |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 70713 | Connecticut |
Profile Details
| NPI number | 1033771126 |
|---|---|
| LBN Legal business name | Vercruysse, Jessica Lise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2019 |
| Last updated | Jun 22nd, 2022 - about 2 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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