Provider Demographics
NPI:1942474689
Name:MCCASKILL, JESSICA EDWARDS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:EDWARDS
Last Name:MCCASKILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:BROOKE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:125 FOX HOLW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8511
Mailing Address - Country:US
Mailing Address - Phone:910-295-7546
Mailing Address - Fax:
Practice Address - Street 1:125 FOX HOLW
Practice Address - Street 2:SUITE 210
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8511
Practice Address - Country:US
Practice Address - Phone:910-295-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01318363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical