Provider Demographics
NPI:1487257531
Name:BARRETT, JESSICA (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 FERNWOOD RD STE 506
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1184
Mailing Address - Country:US
Mailing Address - Phone:301-530-1010
Mailing Address - Fax:
Practice Address - Street 1:1625 N GEORGE MASON DR STE 375
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3687
Practice Address - Country:US
Practice Address - Phone:038-424-1887
Practice Address - Fax:703-842-4187
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0007730207X00000X
VA0110007483363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery