Provider Demographics
NPI:1659321057
Name:GIRSKIS, JENNIFER JANE (MS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JANE
Last Name:GIRSKIS
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:GIRSKIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, PA-C
Mailing Address - Street 1:35 FACILITY DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-9438
Mailing Address - Country:US
Mailing Address - Phone:828-452-5042
Mailing Address - Fax:828-452-9225
Practice Address - Street 1:98 DOCTORS DR
Practice Address - Street 2:STE 100
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4501
Practice Address - Country:US
Practice Address - Phone:828-631-8755
Practice Address - Fax:828-631-8777
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00529363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC3440A556Medicare PIN
NC2768461Medicare PIN
ORQ66575Medicare UPIN
NCNC3440CMedicare PIN