Provider Demographics
NPI:1063546752
Name:ROUSE, JESSICA ALICE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ALICE
Last Name:ROUSE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5 PARK STREET
Mailing Address - Street 2:STAR MILL SUITE 3A
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1169
Mailing Address - Country:US
Mailing Address - Phone:802-382-9491
Mailing Address - Fax:855-809-2105
Practice Address - Street 1:5 PARK ST STE 3A
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1169
Practice Address - Country:US
Practice Address - Phone:802-388-7185
Practice Address - Fax:802-388-3445
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-06-28
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Provider Licenses
StateLicense IDTaxonomies
VT0420011761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine