Healthcare Provider Details

I. General information

NPI: 1376203554
Provider Name (Legal Business Name): JESSICA THUY-MAI ARNETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 NORTHEAST DR STE 301
DAVIDSON NC
28036-7438
US

IV. Provider business mailing address

22330 TORRENCE CHAPEL RD
CORNELIUS NC
28031-6791
US

V. Phone/Fax

Practice location:
  • Phone: 704-894-9309
  • Fax:
Mailing address:
  • Phone: 706-799-1263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12089
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: