Healthcare Provider Details

I. General information

NPI: 1699425702
Provider Name (Legal Business Name): JESSICA DANIELLE BATTAGLIA PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FIRSTHEALTH FAMILY MEDICINE 313 TEAL DRIVE
RAEFORD NC
28376
US

IV. Provider business mailing address

313 TEAL DRIVE
RAEFORD NC
28376
US

V. Phone/Fax

Practice location:
  • Phone: 910-904-2350
  • Fax: 910-904-1021
Mailing address:
  • Phone: 910-904-2350
  • Fax: 910-904-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-11966
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: