National Provider Identifier

Jessica Nixon Moore, PA-C

Jessica Nixon Moore, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 922-5067.

NPI 1629114772Rochester, NYPhysician Assistant

Profile Overview

NPI
1629114772
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
January 29, 2007
Last Updated
February 22, 2013

Practice Location

  • 1425 Portland Ave
  • Department Of Medicine- Box 287
  • Rochester, NY 14621-3001

Phone: (585) 922-5067

Mailing Address

  • 1425 Portland Ave
  • Deptartment Of Medicine- Box 287
  • Rochester, NY 14621-3001

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1629114772
Entity Type
Individual
Last Name
Moore
First Name
Jessica
Middle Name
Nixon
Credential
PA-C
Mailing Street Address
1425 Portland Ave
Mailing Address Line 2
Deptartment Of Medicine- Box 287
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621-3001
Mailing Country
US
Mailing Phone
(585) 922-5067
Mailing Fax
(585) 922-2908
Practice Street Address
1425 Portland Ave
Practice Address Line 2
Department Of Medicine- Box 287
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3001
Practice Country
US
Practice Phone
(585) 922-5067
Enumeration Date
January 29, 2007
Last Updated
February 22, 2013
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
01131126 RGH (NY)