Provider Demographics
NPI:1972750222
Name:DEMPSEY, JENNIFER LAUREN (PA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LAUREN
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LAUREN
Other - Last Name:GILLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5536 SHADY PINE CT
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2918
Mailing Address - Country:US
Mailing Address - Phone:910-583-8670
Mailing Address - Fax:
Practice Address - Street 1:4-2817 REILLY ROAD
Practice Address - Street 2:WOMACK ARMY MEDICAL CTR
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant