Healthcare Provider Details

I. General information

NPI: 1437031564
Provider Name (Legal Business Name): JASMINE ROSE ESSA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

530 N PATTERSON AVE UNIT 181
WINSTON SALEM NC
27101-4272
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-2011
  • Fax:
Mailing address:
  • Phone: 904-868-2013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number0010-15457
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: