Healthcare Provider Details

I. General information

NPI: 1497738744
Provider Name (Legal Business Name): JERI ALLISON MCCARSON DNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MEMORIAL DR
JACKSONVILLE NC
28546-6333
US

IV. Provider business mailing address

245 MEMORIAL DR
JACKSONVILLE NC
28546-6333
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-1499
  • Fax: 910-355-0404
Mailing address:
  • Phone: 910-353-4333
  • Fax: 910-355-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number65
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number0992699
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0992699
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: