Individual
JESSICA BRYS-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
10589 E NC 97, ROCKY MOUNT, NC 27803-9208
(252) 442-1807
(252) 442-1649
Mailing address
PO BOX 7867, ROCKY MOUNT, NC 27804-0867
(252) 442-1807
(252) 442-1649
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001000252
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213660
MEDCOST ID
NC
01
—
416456
WELLPATH ID
NC
01
—
7708741
AETNA ID
NC
Enumeration date
03/24/2006
Last updated
04/11/2012
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