Provider Demographics
NPI:1871568311
Name:FUHRMAN, JESSICA M (PA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:FUHRMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:M
Other - Last Name:FUHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2315 MYRTLE ST STE L10
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4611
Mailing Address - Country:US
Mailing Address - Phone:814-454-2401
Mailing Address - Fax:814-459-5992
Practice Address - Street 1:2315 MYRTLE ST STE L10
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4611
Practice Address - Country:US
Practice Address - Phone:814-454-2401
Practice Address - Fax:814-459-5992
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054367363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00319817OtherRAIL ROAD MEDICARE
INQ63405Medicare UPIN
IN058940UUUMedicare PIN
INP00319817Medicare PIN
IN058940UUUMedicare ID - Type Unspecified