NPI 1578884458 · live from the CMS NPI Registry
Jessica M Acosta, PA-C
Physician Assistant, Surgical in Oklahoma City, OK. National Provider Identifier 1578884458, active.
NPI record
| NPI | 1578884458 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 608 Nw 9th St Ste 5010, Oklahoma City, OK 73102 |
| Practice phone | 405-979-7875 |
| Mailing address | 3300 Nw Expressway, Oklahoma City, OK 73112 |
| Enumerated | June 15, 2010 |
| Last updated | April 13, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | — |
| Physician Assistant, Surgical primary | 363AS0400X | 2934 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.