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General NPI Number Information
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NPI Number | 1760937452
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Entity Type | Individual
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Provider Name | JEANNE MARIE DAMORE VACCA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 729 3RD AVENUE
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City | NEW BERN
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State | NC
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Zip | 28560
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Country | US
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Telephone | 252-633-8353
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-0068
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Country | US
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Telephone | 252-635-3906
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Fax | 252-224-0378
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5015567
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License Number State | NC
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