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NPI 1831269505

NPI 1831269505 : JENNIFER MARTINE PASTERNACK MD : MILL SPRING, NC

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General NPI Number Information
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    NPI Number           |    1831269505
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER MARTINE PASTERNACK MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/09/2006
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    Last Update Date     |    07/13/2015
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Provider Practice Location Address
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    Address Line         |    101 HEALING FARM LN 
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    City                 |    MILL SPRING
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    State                |    NC
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    Zip                  |    28756-5808
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    Country              |    US
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    Telephone            |    828-894-5557
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    Fax                  |    828-894-7120
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Provider Business Mailing Address
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    Address Line         |    101 HEALING FARM LN 
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    City                 |    MILL SPRING
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    State                |    NC
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    Zip                  |    28756-5808
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    Country              |    US
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    Telephone            |    828-894-5557
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    Fax                  |    828-894-7120
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    2014-00045
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    License Number State |    NC
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