Individual
DR. JESSICA DANIELLE REBAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19475 OLD JETTON RD STE 200, CORNELIUS, NC 28031-6591
(704) 316-5136
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RTL24-0982
NC
Other
Enumeration date
03/21/2024
Last updated
06/12/2024
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