Basic Information
| Provider Information | |||||||||
| NPI: | 1467474775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JESSUP | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | HENDRICK | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 518 VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273307266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197744296 | ||||||||
| FaxNumber: | 9103239577 | ||||||||
| Practice Location | |||||||||
| Address1: | 1702 OWEN DR | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103233184 | ||||||||
| FaxNumber: | 9103239577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 22931 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.