Provider Demographics
NPI:1609657188
Name:LINDAUER, JESSICA RACHEL (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RACHEL
Last Name:LINDAUER
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:325 NC HIGHWAY 55 W
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-8527
Mailing Address - Country:US
Mailing Address - Phone:919-658-5900
Mailing Address - Fax:910-267-8981
Practice Address - Street 1:325 NC-55 WEST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365
Practice Address - Country:US
Practice Address - Phone:919-658-5900
Practice Address - Fax:910-267-8981
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2024-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-13663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine