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NPI Code Detail

MEDICARE: JANELLE BLUDWORTH PA-C

MEDICARE: JANELLE BLUDWORTH 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 Assistant0010-07853NC

General Provider Information

NPI Number : 1336647247
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE BLUDWORTH PA-C
Provider Business Mailing Address
First Line : 1414 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7505
Country : US
Telephone Number : 910-763-7363
Fax Number :
Provider Business Practice Location Address
First Line : 1414 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7505
Country : US
Telephone Number : 910-763-7363
Fax Number : 910-251-8296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2018
Last Update Date : 03/25/2021

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Directions to “ JANELLE BLUDWORTH PA-C” Practice Location

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