Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 2019014906 | MO |
NPI | 1477114510 |
---|---|
Provider Name | Jessica Billham |
First Address | Chesterfield, MO 63017-5529 |
Second Address | Chesterfield, MO 63017-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2019 |
Last Update Date | 27/06/2019 |