Provider Demographics
NPI:1255726709
Name:PARTRIDGE, JENITA (MD)
Entity type:Individual
Prefix:
First Name:JENITA
Middle Name:
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ROGERS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-5745
Mailing Address - Country:US
Mailing Address - Phone:919-385-2120
Mailing Address - Fax:919-385-2144
Practice Address - Street 1:3000 ROGERS RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5743
Practice Address - Country:US
Practice Address - Phone:919-385-2120
Practice Address - Fax:919-385-2744
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-03138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics