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NPI Code Detail

MEDICARE: MRS. JESSICA MARIE PINEDA PA-C

MEDICARE: MRS. JESSICA MARIE PINEDA PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-03704NC

General Provider Information

NPI Number : 1053660613
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA MARIE PINEDA PA-C
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 214 CLEVELAND AVE
Second Line :
City : KINGS MOUNTAIN
State : NC
Zip : 28086-3106
Country : US
Telephone Number : 704-730-1228
Fax Number : 704-730-1231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 02/24/2020

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Directions to “ MRS. JESSICA MARIE PINEDA PA-C” Practice Location

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