Individual
JESSICA DANIELLE RAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
938 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4331
(919) 235-1525
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-15078
NC
363A00000X
Physician Assistant
PA2166
KY
363A00000X
Physician Assistant
PA9115447
FL
363AM0700X
Medical Physician Assistant
Primary
0010-15078
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124573530
—
NC
Enumeration date
08/16/2016
Last updated
06/05/2025
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