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
Phone: (910) 332-0241
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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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