Individual
MRS. JACQUELYN DIANE VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1236 HUFFMAN MILL RD STE 130, BURLINGTON, NC 27215-8700
(336) 438-1060
Mailing address
2087 CAMPUS BOX, ELON, NC 27244-2010
(336) 278-6847
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08997
NC
Other
Enumeration date
04/03/2019
Last updated
08/25/2021
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