Healthcare Provider Details

I. General information

NPI: 1427973908
Provider Name (Legal Business Name): JEFFREY PAULSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W TRADE ST
DALLAS NC
28034-1544
US

IV. Provider business mailing address

4110 DUPLIN DR
CHARLOTTE NC
28214-2640
US

V. Phone/Fax

Practice location:
  • Phone: 704-922-7187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-11982
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: