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Individual

MS. JENNIFER ELIZABETH ATWATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
(919) 557-7668
Mailing address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
(919) 557-7668

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001001108
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001001108
NC MEDICAL BOARD
NC
Enumeration date
11/05/2007
Last updated
03/25/2010
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