Individual
JEFFERY JUSTIN KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
104 PHYSICIANS PARK DR, ROCKINGHAM, NC 28379-5204
(910) 895-1989
(910) 895-9666
Mailing address
PO BOX 843013, BOSTON, MA 02284-3013
(910) 895-1989
(910) 895-9666
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
103521
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103521
STATE LICENSE
NC
Enumeration date
10/07/2005
Last updated
10/22/2014
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