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Individual

JESSICA LYNN GRASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4235 S NEW HOPE RD, GASTONIA, NC 28056-8453
(704) 825-4750
(704) 825-6985
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
182781
NC
207Q00000X
Family Medicine Physician
Primary
2015-00273
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1780944314
NC
01
19DJ7
BCBS OF NC
NC
Enumeration date
05/16/2012
Last updated
02/07/2022
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