Provider Demographics
NPI:1447768502
Name:MEISENHELDER, JESSICA MCCULLEN (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MCCULLEN
Last Name:MEISENHELDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:HOPE
Other - Last Name:MCCULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9479
Mailing Address - Country:US
Mailing Address - Phone:919-580-0000
Mailing Address - Fax:919-580-0209
Practice Address - Street 1:203 COX BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9479
Practice Address - Country:US
Practice Address - Phone:919-580-0000
Practice Address - Fax:919-580-0209
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily