Provider Demographics
NPI:1306679329
Name:HUNT, JORDAN SHEA (PA-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:SHEA
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 LAMB RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-5216
Mailing Address - Country:US
Mailing Address - Phone:336-309-6983
Mailing Address - Fax:
Practice Address - Street 1:269 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NC
Practice Address - Zip Code:28128-6435
Practice Address - Country:US
Practice Address - Phone:980-323-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-14488363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant