| Doctor Name: | JESSICA DE GRASSE |
| NPI Number: | 1013314368 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | R181291 |
| Business Practice Address: | 6201 Greenbelt Road Suite L1 College Park, MD - 20740 |
| Business Phone Number: | 3013461900 |
| Business Fax Number: | |
| Mailing Address: | 6201 Greenbelt Rd, Suite L1 BERWYN HEIGHTS |
| State: | MD |
| Postal Code: | 207402354 |
| Phone Number: | 3013451900 |
| Fax Number: | |
| NPI Enumeration Date: | 12/02/2014 |
| NPI Last Update Date: | 12/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R181291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |