Individual
MRS. VIRGINIA A JETHRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1110 SE CARY PKWY, SUITE 206, CARY, NC 27518-7420
(919) 463-1101
(919) 463-1110
Mailing address
1110 SE CARY PKWY, SUITE 206, CARY, NC 27518-7420
(919) 463-1101
(919) 463-1110
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
103811
NC
363AM0700X
Medical Physician Assistant
MA-052635
PA
Other
Enumeration date
03/29/2006
Last updated
04/01/2021
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