Individual
JESSICA LYNN HINAMAN DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-2648
(336) 716-2255
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2025-01754
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
07/28/2025
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