Provider Demographics
NPI:1861770794
Name:SPEARES, JESSICA (RPA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SPEARES
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5155
Mailing Address - Country:US
Mailing Address - Phone:585-342-5665
Mailing Address - Fax:585-342-2345
Practice Address - Street 1:340 ARNETT BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1147
Practice Address - Country:US
Practice Address - Phone:585-235-2250
Practice Address - Fax:585-235-0011
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY23014893363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical