Individual
MS. MILDRED WHITE JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2023 S 17TH ST, WILMINGTON, NC 28401-6600
(910) 251-6550
Mailing address
2023 S 17TH ST, WILMINGTON, NC 28401-6600
(910) 251-6550
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
044008
NC
163WC0400X
Case Management Registered Nurse
044008
NC
163WP0808X
Psychiatric/Mental Health Registered Nurse
044008
NC
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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