Provider Demographics
NPI:1114772381
Name:WASSERMAN, JENNA RACHEL (MD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RACHEL
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DRIVE ROOM 30319
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7160
Mailing Address - Country:US
Mailing Address - Phone:984-974-5217
Mailing Address - Fax:984-974-9646
Practice Address - Street 1:77 VILCOM CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1875
Practice Address - Country:US
Practice Address - Phone:984-974-5217
Practice Address - Fax:984-974-9646
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program