Provider Demographics
NPI:1649027863
Name:ADAMS, JESSICA LANE
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-2804
Mailing Address - Country:US
Mailing Address - Phone:980-241-2963
Mailing Address - Fax:
Practice Address - Street 1:419 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2804
Practice Address - Country:US
Practice Address - Phone:980-241-2963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program