Provider Demographics
NPI:1891366993
Name:SAMMONS, JOCELYN NICOLE (BSN, RN)
Entity Type:Individual
Prefix:MISS
First Name:JOCELYN
Middle Name:NICOLE
Last Name:SAMMONS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN ROAD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-1140
Mailing Address - Country:US
Mailing Address - Phone:517-317-2689
Mailing Address - Fax:
Practice Address - Street 1:1000 N BUCHANAN BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1140
Practice Address - Country:US
Practice Address - Phone:517-317-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC325939163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse