Individual
JESSICA JELAPON YAEMMONGKOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6324 FAIRVIEW RD STE 420, CHARLOTTE, NC 28210-3372
(704) 316-1120
Mailing address
PO BOX 604136, CHARLOTTE, NC 28260-4136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12625
NC
363AS0400X
Surgical Physician Assistant
0010-12625
NC
Other
Enumeration date
01/06/2022
Last updated
01/15/2026
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