Jessica Dawn Achatz, ATC, LAT

Individual provider Active NPI Athletic Trainer · Cary, NC

NPI 1255692091 · NPPES record last updated Jun 7, 2012

Key facts

NPI
1255692091
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1761 (NC)
Practice address
113 Ribbon LN Apt M
Cary, NC 27518-6887
Phone
(719) 469-9608
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1761NCMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1761 NC Yes

Addresses

Primary practice location

113 Ribbon LN Apt M
Cary, NC 27518-6887

Mailing address

113 Ribbon LN Apt M
Cary, NC 27518-6887
Phone (719) 469-9608

Other identifiers

IdentifierTypeStateIssuer
2000003551OtherNCBOC
1761OtherNCNCBATE

Other providers in Cary, NC

All providers in Cary, NC · Athletic Trainer in North Carolina

Sources for this page

Verify at the official NPI Registry.