Provider Demographics
NPI:1740520121
Name:SEKELSKI, JESSICA M (PA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:SEKELSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HAYWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-4405
Mailing Address - Country:US
Mailing Address - Phone:828-237-8001
Mailing Address - Fax:828-237-8002
Practice Address - Street 1:107 HAYWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-4405
Practice Address - Country:US
Practice Address - Phone:828-237-8001
Practice Address - Fax:828-237-8002
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-03911363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical