Provider Demographics
NPI:1851849434
Name:PEARSON, JEANNINE NOBLE (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:JEANNINE
Middle Name:NOBLE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-6119
Mailing Address - Country:US
Mailing Address - Phone:919-721-3252
Mailing Address - Fax:
Practice Address - Street 1:292 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7059
Practice Address - Country:US
Practice Address - Phone:910-757-0408
Practice Address - Fax:910-757-0413
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist