Individual
JESSICA MUCKENFUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6675 FALLS OF NEUSE RD STE 123, RALEIGH, NC 27615-6857
(919) 999-3604
Mailing address
6675 FALLS OF NEUSE RD STE 123, RALEIGH, NC 27615-6857
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014927
NC
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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