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General NPI Number Information
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NPI Number | 1457245086
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Entity Type | Individual
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Provider Name | JADYN NOVAK PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | PO BOX 1229
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City | WEAVERVILLE
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State | CA
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Zip | 96093-1229
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Country | US
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Telephone | 530-623-2687
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Fax |
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Provider Business Mailing Address
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Address Line | 45585 146TH ST
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City | SUMMIT
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State | SD
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Zip | 57266-5205
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Country | US
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Telephone | 605-949-1371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PA66491
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License Number State | CA
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