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NPI Code Detail

MEDICARE: STEPHANIE MARIE JASSO

MEDICARE: STEPHANIE MARIE JASSO
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
1363LA2100XAcute Care Nurse Practitioner5023745NC

General Provider Information

NPI Number : 1952268278
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MARIE JASSO
Provider Business Mailing Address
First Line : 1816 IRON HORSE DR
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-7180
Country : US
Telephone Number : 336-413-4179
Fax Number :
Provider Business Practice Location Address
First Line : 6915 VILLAGE MEDICAL CIR
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8002
Country : US
Telephone Number : 336-893-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ STEPHANIE MARIE JASSO ” Practice Location

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