Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301115368 | MI |
NPI | 1003308057 |
---|---|
Provider Name | Dr. Jessica Frost |
First Address | Lansing, MI 48912-1811 |
Second Address | Lansing, MI 48912-1811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 05/06/2018 |