Provider Demographics
NPI:1598738866
Name:HOH, JENA ENGEL (PAC)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:ENGEL
Last Name:HOH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:919-562-2288
Mailing Address - Fax:919-562-2225
Practice Address - Street 1:3213 ROGERS RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3805
Practice Address - Country:US
Practice Address - Phone:919-562-2288
Practice Address - Fax:919-562-2225
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102845363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2754107Medicare PIN
P46991Medicare UPIN