| Doctor Name: | JESSICA LEE ORD |
| NPI Number: | 1598077638 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPA-C |
| License Number: | 014041 |
| Business Practice Address: | 15195 Heathcote Blvd Suite 330 Haymarket, VA - 201696242 |
| Business Phone Number: | 5712480167 |
| Business Fax Number: | 5712480173 |
| Mailing Address: | 15195 Heathcote Blvd, Suite 330 HAYMARKET |
| State: | VA |
| Postal Code: | 201696242 |
| Phone Number: | 5712480167 |
| Fax Number: | 5712480173 |
| NPI Enumeration Date: | 07/06/2010 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 014041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |