Provider Demographics
NPI:1285326835
Name:FINNEGAN, JESSICA MARIE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 N 5TH ST APT 136
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2668
Mailing Address - Country:US
Mailing Address - Phone:269-985-8190
Mailing Address - Fax:
Practice Address - Street 1:6418 DEANS HILL RD STE 1
Practice Address - Street 2:
Practice Address - City:BERRIEN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49102-8714
Practice Address - Country:US
Practice Address - Phone:269-815-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist