Jill R Czaja, PA-C
Individual provider Active NPI Physician Assistant · Spruce Pine, NC
NPI 1740326933 · NPPES record last updated Aug 7, 2013
Key facts
- NPI
- 1740326933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 103615 (NC)
- Practice address
- 7968 Hwy 19E
BRMC-Mayland Campus
Spruce Pine, NC 28777-6011 - Phone
- (828) 765-4111
- Fax
- (828) 765-5676
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103615 | NC | MD | Neonatal-Perinatal Medicine Physician |
Interoperability endpoints
- jillczaja@brpami.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103615 | NC | Yes |
Addresses
Primary practice location
7968 Hwy 19E
BRMC-Mayland Campus
Spruce Pine, NC 28777-6011
Mailing address
7968 Hwy 19E
BRMC-Mayland Campus
Spruce Pine, NC 28777-6011
Phone (828) 765-4111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8103074 | Medicaid | NC |
Other providers in Spruce Pine, NC
- Joshua Shane Cooke
- Cornerstone Family Health, PLLC
- David Arthur Cort
- Amanda Cranston
- Bruce Dennis Crawford
- Brittany Alyssa Dalama
- Michael Damico
- Dayspring Family Health & Wellness, PLLC
- Lucia Derks
- Don Waldrop Enterprises, Inc
All providers in Spruce Pine, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.