JESSICA M FETTERMAN PA
NPI 1316025679
Physician Assistant - Medical in Manlius, NY

Q: What is Jessica Fetterman's NPI number?

The NPI number for Jessica Fetterman is 1316025679. It was assigned to this individual provider in the NPPES registry on November 2, 2006.

Q: What is Jessica Fetterman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Fetterman was last updated on September 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 02, 2006

4282 TROUT LILLY LN, MANLIUS, NY 13104(315) 877-2402 Get Directions Write a Review

NPPES record last updated: September 7, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jessica M Fetterman Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA M FETTERMAN PA (NPI 1316025679) is an individual medical provider in Manlius, New York and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1316025679

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameJESSICA M FETTERMANCredential: PA

Location Address4282 TROUT LILLY LNManlius, NY 13104-9807

Mailing Address4282 Trout Lilly LnManlius, NY 13104-9807 · (315) 877-2402

Phone(315) 877-2402

Sole ProprietorNo

Enumeration DateNovember 2, 2006

Last NPPES UpdateSeptember 7, 2010

✔ NPI 1316025679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Also ListedPhysician AssistantTaxonomy 363A00000X · License 5601004474 (MI)

4282 TROUT LILLY LN, Manlius, NY 13104

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Other Identifiers 2

Medicare UPINP38225MI

Medicare ID-Type Unspecified0M52870108MI

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Fetterman's NPI number?

The NPI number for Jessica Fetterman is 1316025679. It was assigned to this individual provider in the NPPES registry on November 2, 2006.

Where is Jessica Fetterman located?

Jessica Fetterman practices at 4282 Trout Lilly Ln, Manlius, NY 13104. The listed phone number is (315) 877-2402.

What is Jessica Fetterman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Jessica Fetterman was last updated on September 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.