MEDICARE: JENNA MARIE MEYERSON 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
1	363A00000X	Physician Assistant		NC

General Provider Information

NPI Number	:	1659252021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MARIE MEYERSON PA-C

Provider Business Mailing Address
First Line	:	40 DUKE MEDICINE CIR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-4000
Country	:	US
Telephone Number	:	919-684-6437
Fax Number	:	919-681-8147

Provider Business Practice Location Address
First Line	:	4220 N ROXBORO ST FL 1
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1826
Country	:	US
Telephone Number	:	919-684-6437
Fax Number	:

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

Provider Enumeration Date	:	09/10/2025
Last Update Date	:	12/01/2025

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