Provider Demographics
NPI:1265003909
Name:WESSON, JESSICA POTTER (DNP-AGNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:POTTER
Last Name:WESSON
Suffix:
Gender:F
Credentials:DNP-AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MULBERRY ST SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5414
Mailing Address - Country:US
Mailing Address - Phone:828-759-4960
Mailing Address - Fax:828-759-4960
Practice Address - Street 1:212 MULBERRY ST SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5414
Practice Address - Country:US
Practice Address - Phone:828-759-4960
Practice Address - Fax:828-759-4960
Is Sole Proprietor?:No
Enumeration Date:2021-07-04
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCWESS-7144N363L00000X
NC5014695363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner