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NPI Code Detail

MEDICARE: JENNIFER DOVE NP

MEDICARE: JENNIFER DOVE NP
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
1363L00000XNurse Practitioner5008806NC
2363LP2300XPrimary Care Nurse Practitioner238751NC

General Provider Information

NPI Number : 1780138479
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DOVE NP
Provider Business Mailing Address
First Line : 823 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 823 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3703
Country : US
Telephone Number : 910-642-6121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2016
Last Update Date : 01/17/2020

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