Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica Nicole Souther

Individual provider Physician Assistant · NPI 1669306791

Jessica Nicole Souther is a Physician Assistant in Revere, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2026.

Licensed in
MA
In the registry since
2026

Practice location Address checks out

21 Revere Beach Blvd Apt 505
Revere, MA 02151-3771
Phone: (484) 798-8841
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MA)

Record details

NPI number1669306791
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 12, 2026
Last updated in NPPESJune 12, 2026
Certification dateJune 10, 2026

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