Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD 073876L | PA |
NPI | 1104881440 |
---|---|
Provider Name | Dr. Jessica Ann Henry |
First Address | Pittsburgh, PA 15224-1722 |
Second Address | Pittsburgh, PA 15224-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1009850730001 | (05) | PA |
2560545 | (05) | OH |
3810003580 | (05) | WV |