Provider Demographics
NPI:1790118743
Name:FRANCIS, JODY (PMHNP)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7614 PONTCHARTRAIN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-3141
Mailing Address - Country:US
Mailing Address - Phone:910-350-8252
Mailing Address - Fax:
Practice Address - Street 1:3201 EDWARDS MILL RD STE 141
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5371
Practice Address - Country:US
Practice Address - Phone:919-443-2360
Practice Address - Fax:919-800-3039
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC198736363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health