Provider Demographics
NPI:1609618461
Name:IRCINK, JESSICA ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ANN
Last Name:IRCINK
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 1:100 BALDWIN BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2375
Mailing Address - Country:US
Mailing Address - Phone:509-496-1177
Mailing Address - Fax:
Practice Address - Street 1:100 BALDWIN BLVD
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2375
Practice Address - Country:US
Practice Address - Phone:509-496-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant