Individual
JENNIFER S. BERETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2555 COURT DR STE 450, GASTONIA, NC 28054
(704) 671-7652
(704) 671-7656
Mailing address
2555 COURT DR STE 450, GASTONIA, NC 28054-2191
(704) 671-7652
(704) 671-7656
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5007938
NC
363L00000X
Nurse Practitioner
R205065
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
237317
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730007
NSC
NC
Enumeration date
05/09/2015
Last updated
10/21/2021
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