MRS. JESSICA LEA PETTY IDC
NPI 1407113111
Military Health Care Provider - Independent Duty Corpsman in Jacksonville, NC

Q: What is Jessica Petty's NPI number?

The NPI number for Jessica Petty is 1407113111. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Q: What is Jessica Petty's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Petty was last updated on April 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 19, 2012

194 MAREADY RD, JACKSONVILLE, NC 28546(904) 240-9350 Get Directions Write a Review

NPPES record last updated: April 19, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Jessica Lea Petty Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JESSICA LEA PETTY IDC (NPI 1407113111) is an individual independent duty corpsman provider in Jacksonville, North Carolina and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1407113111

Entity TypeIndividualFemale

Primary Taxonomy1710I1002X

Provider Legal NameMRS. JESSICA LEA PETTYCredential: IDC

Location Address194 MAREADY RDJacksonville, NC 28546-9332

Mailing AddressPsc Box 20125, Clr-27 Group Aid StationCamp Lejeune, NC 28542-0125 · (904) 240-3350

Phone(904) 240-9350

Sole ProprietorNo

Enumeration DateApril 19, 2012

✔ NPI 1407113111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

194 MAREADY RD, Jacksonville, NC 28546

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Petty's NPI number?

The NPI number for Jessica Petty is 1407113111. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Where is Jessica Petty located?

Jessica Petty practices at 194 Maready Rd, Jacksonville, NC 28546. The listed phone number is (904) 240-9350.

What is Jessica Petty's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Jessica Petty was last updated on April 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.