Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0102204797 | VA |
NPI | 1003235813 |
---|---|
Provider Name | Jessica Saxbury |
First Address | Norfolk, VA 23507-1910 |
Second Address | Suffolk, VA 23435-2048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 17/03/2018 |