Individual
JENNIE MARIE DELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1896 REMOUNT RD, GASTONIA, NC 28054-7414
(704) 512-3930
(704) 865-2478
Mailing address
PO BOX 60099, CHARLOTTE, NC 28260-0099
(704) 512-3930
(704) 865-2478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101002
NC
363AM0700X
Medical Physician Assistant
101002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457389488
—
NC
05
—
2844PA
—
SC
05
—
8101844
—
NC
Enumeration date
06/29/2006
Last updated
04/20/2017
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