Individual provider · Type 1 NPI

Jessica J. Doutaz, MS, AGNP

Adult Health Nurse Practitioner · Statesville, NC

NPI number 1194106674 Active

Practice location

208 Old Mocksville Rd
Statesville, NC 28625-1953

Fax (704) 924-5360

Mailing address

PO Box 1845
Statesville, NC 28687-1845

Other practice locations

  • 805 W Wade Hampton Blvd Ste C, Greer, SC 29650-1311 · (864) 655-6615

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200X24954 (SC)
Adult Health Nurse Practitioner Primary 363LA2200X5021443 (NC)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1194106674

Jessica J. Doutaz, MS, AGNP's National Provider Identifier is 1194106674, issued on Jun 10, 2015. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Statesville, NC. The record was last updated on Feb 19, 2026.