Individual
JENNA STAPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1301 FAYETTEVILLE STREET, DURHAM, NC 27717
(919) 956-4000
Mailing address
803 DEMERIUS ST APT H3, DURHAM, NC 27701-1661
(919) 308-6518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05217
NC
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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