Provider Demographics
NPI:1326742339
Name:BADALAMENTI, JESSICA MASON (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MASON
Last Name:BADALAMENTI
Suffix:
Gender:F
Credentials:RN
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:414 DAIRY FARM DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-6756
Mailing Address - Country:US
Mailing Address - Phone:847-660-4719
Mailing Address - Fax:
Practice Address - Street 1:414 DAIRY FARM DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-6756
Practice Address - Country:US
Practice Address - Phone:847-660-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC284283163WS0200X, 390200000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program