Individual
JANE MARIE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3000 ERWIN RD, DURHAM, NC 27705-4504
(919) 698-2149
Mailing address
308 HASSELLWOOD DR, CARY, NC 27518-3013
(919) 606-3086
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4397
NC
2251P0200X
Pediatric Physical Therapist
Primary
4397
NC
2251X0800X
Orthopedic Physical Therapist
4397
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1017P
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/10/2006
Last updated
03/26/2025
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