Provider Demographics
NPI:1194098681
Name:WELLS-BURRIS, JESSICA MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARIE
Last Name:WELLS-BURRIS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1226 N SHARTEL AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-5403
Mailing Address - Country:US
Mailing Address - Phone:405-605-8280
Mailing Address - Fax:405-232-8008
Practice Address - Street 1:701 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5403
Practice Address - Country:US
Practice Address - Phone:405-232-8003
Practice Address - Fax:405-232-8008
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2019-05-09
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Provider Licenses
StateLicense IDTaxonomies
OK2102363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical