Individual
JORDANN ELIZABETH DEACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2630 E 7TH ST STE 200, CHARLOTTE, NC 28204-4319
(704) 364-6110
(704) 364-4245
Mailing address
2630 E 7TH ST STE 200, CHARLOTTE, NC 28204-4319
(704) 364-6110
(704) 364-4245
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0010-12912
NC
Other
Enumeration date
06/09/2022
Last updated
09/27/2023
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