Individual
JACQUELINE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
510 CAROLINA BAY DR, STE 110, WILMINGTON, NC 28403-2041
(910) 662-6000
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104116
NC
Other
Enumeration date
09/27/2006
Last updated
01/20/2021
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