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Individual

JENISE VICTORIA BACON MENSHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1240 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-7060
Mailing address
2020 KILDARE WOODS DR, GREENSBORO, NC 27407-6370
(404) 556-1039

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104189
NC
363A00000X
Physician Assistant
4331
GA
363A00000X
Physician Assistant
PA0961
TN

Other

Enumeration date
07/19/2006
Last updated
08/10/2012
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