=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750090411
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER KIRSTEN PARIS-COSSU
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2022
-----------------------------------------------------
Last Update Date | 11/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 263 HAYWOOD ST STE 104
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-2629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-423-0780
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 47 MARLOWE RD
-----------------------------------------------------
City | FAIRVIEW
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28730-8646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-423-0780
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 1085
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------