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JESSICA MARIE VAN KOOTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
106 LANGTREE VILLAGE DR STE 200, MOORESVILLE, NC 28117-7594
(704) 316-4830
(704) 316-4831
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2021-02429
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/02/2017
Last updated
02/09/2022
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