Individual
MS. JESSICA LYNN DANISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
155 MEMORIAL DRIVE, PINEHURST, NC 28374-8710
(910) 715-2164
(910) 715-1247
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0102203790
VA
2084N0400X
Neurology Physician
Primary
2017-01821
NC
2084N0400X
Neurology Physician
OT013667
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477874618
—
NC
05
—
147874618
—
VA
01
—
19RDR
BCBS OF NC
NC
01
—
NCY8960322
MEDICARE
NC
Enumeration date
06/22/2010
Last updated
09/23/2024
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