Individual
JESSICA BETH JASKOLKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1606 WELLINGTON AVE, SUITE E, WILMINGTON, NC 28401-7747
(910) 452-1999
(910) 452-1883
Mailing address
1606 WELLINGTON AVE, SUITE E, WILMINGTON, NC 28401-7747
(910) 452-1999
(910) 452-1883
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2008-00672
NC
208000000X
Pediatrics Physician
24142
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810019099
—
WV
Enumeration date
04/20/2007
Last updated
07/03/2014
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