Provo, Jessica

Provo, Jessica is an individual health care provider with primary practice located at 1333 S Dickinson Dr , Leland NC 28451-6430. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Provo, Jessica can be contacted via phone (910) 332-0241.

Contact Information

Primary practice address
1333 S Dickinson Dr Leland NC 28451-6430
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2019-00724 North Carolina

Profile Details

NPI number 1699121368
LBN Legal business name Provo, Jessica
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2016
Last updated Mar 29th, 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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