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NPI Code Detail

MEDICARE: JESSICA WHITNEY INGEMANSEN PA-C

MEDICARE: JESSICA WHITNEY INGEMANSEN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-15873NC
2363A00000XPhysician AssistantPAC0759ND

General Provider Information

NPI Number : 1659841542
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA WHITNEY INGEMANSEN PA-C
Provider Business Mailing Address
First Line : PO BOX 936857
Second Line :
City : ATLANTA
State : GA
Zip : 31193-6857
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-2606
Fax Number : 910-815-5698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 02/05/2026

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Directions to “ JESSICA WHITNEY INGEMANSEN PA-C” Practice Location

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