Individual
JADA MARIE DILLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11640 NORTHPARK DR STE 200, WAKE FOREST, NC 27587-5741
(919) 436-4124
Mailing address
11640 NORTHPARK DR STE 200, WAKE FOREST, NC 27587-5741
(919) 436-4124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12516
NC
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2022
Last updated
06/24/2024
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