MEDICARE: JESSICA LYNN YACOPINO

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
1	363LA2200X	Adult Health Nurse Practitioner	5021332	NC
2	363L00000X	Nurse Practitioner	5021332	NC
3	163W00000X	Registered Nurse	302264	NC

General Provider Information

NPI Number	:	1306609573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYNN YACOPINO

Provider Business Mailing Address
First Line	:	124 E GATE CITY BLVD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-1457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 WILLARD DAIRY RD STE 200
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8351
Country	:	US
Telephone Number	:	336-884-3800
Fax Number	:	336-884-3801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2024
Last Update Date	:	04/14/2026

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