Defelice, Jeanette Elizabeth Wilson

Defelice, Jeanette Elizabeth Wilson is an individual health care provider with primary practice located at 1240 Huffman Mill Road , Burlington NC 27215-8700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Defelice, Jeanette Elizabeth Wilson can be contacted via phone (336) 538-8471.

Contact Information

Primary practice address
1240 Huffman Mill Road Burlington NC 27215-8700
Phone: (336) 538-8471
Fax: (336) 538-8161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5005058 North Carolina

Profile Details

NPI number 1972807790
LBN Legal business name Defelice, Jeanette Elizabeth Wilson
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2011
Last updated Sep 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972807790 NPPES
North Carolina MEDICAID 7004905

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