Provider Demographics
NPI:1255604013
Name:KRESSEN, JAYME L (AGNP-C, RN, CSA)
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:L
Last Name:KRESSEN
Suffix:
Gender:F
Credentials:AGNP-C, RN, CSA
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:L
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSA
Mailing Address - Street 1:1306 S KING ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-9663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1306 S KING ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-9663
Practice Address - Country:US
Practice Address - Phone:252-794-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2024-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC339008363LG0600X, 163W00000X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant