Individual
JESSICA WINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4674
(919) 989-4058
Mailing address
3701 ASHBROOK DR NW APT 301, WILSON, NC 27896-7624
(910) 736-6895
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28470
NC
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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