Healthcare Provider Details

I. General information

NPI: 1073189916
Provider Name (Legal Business Name): JESSICA ANN RAHM FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 BATTLE CREEK RD
HORSE SHOE NC
28742-4722
US

IV. Provider business mailing address

185 FLETCHER ACADEMY DR
FLETCHER NC
28732-8808
US

V. Phone/Fax

Practice location:
  • Phone: 828-753-9194
  • Fax: 828-693-4871
Mailing address:
  • Phone: 843-901-0403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5014560
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: