Individual
MS. JENNIFER ANN THURMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14214 BALLANTYNE LAKE RD, SUITE 100, CHARLOTTE, NC 28277-3372
(704) 667-2650
(704) 544-0172
Mailing address
PO BOX 602478, CHARLOTTE, NC 28260-2478
(704) 667-2650
(704) 544-0172
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-03561
NC
363AM0700X
Medical Physician Assistant
2064
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215207667
—
NC
05
—
8102627
—
NC
Enumeration date
01/03/2012
Last updated
06/13/2014
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