Provider Demographics
NPI:1376797472
Name:JERNIGAN, NICHOLAS ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ALLEN
Last Name:JERNIGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:98 DOCTORS DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-4503
Mailing Address - Country:US
Mailing Address - Phone:828-586-9642
Mailing Address - Fax:828-586-9673
Practice Address - Street 1:98 DOCTORS DR
Practice Address - Street 2:STE 300
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4503
Practice Address - Country:US
Practice Address - Phone:828-586-9642
Practice Address - Fax:828-586-9673
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2016-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2010-00748208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine