Provider Demographics
NPI:1164048385
Name:ALFORD, JASON S (FNP-C)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:S
Last Name:ALFORD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 HIGHLAND OAKS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7108
Mailing Address - Country:US
Mailing Address - Phone:336-245-6304
Mailing Address - Fax:336-245-6305
Practice Address - Street 1:820 EASTGROVE CT
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7670
Practice Address - Country:US
Practice Address - Phone:336-408-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily