Individual provider · Type 1 NPI

Jessica Ely Prue, PA-C

Surgical Physician Assistant · Raleigh, NC

NPI number 1871103382 Active

Practice location

3009 New Bern Ave
Raleigh, NC 27610-1214

Call (919) 232-5020 Map

Fax (919) 232-5021

Mailing address

PO Box 603949
Charlotte, NC 28260-3949

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0010-12366 (NC)
Surgical Physician Assistant Primary 363AS0400X0010-12366 (NC)

Surgical Physician Assistant: Definition to come...

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About NPI 1871103382

Jessica Ely Prue, PA-C's National Provider Identifier is 1871103382, issued on Aug 10, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Raleigh, NC. The record was last updated on Apr 28, 2026.