Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jessica Lea Petty, IDC

Individual provider Independent Duty Corpsman · NPI 1407113111

Mrs. Jessica Lea Petty, IDC is an Independent Duty Corpsman in Jacksonville, North Carolina. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

194 Maready Rd
Jacksonville, NC 28546-9332
Phone: (904) 240-9350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1407113111
Entity typeIndividual (Type 1)
GenderFemale
Credentials IDC
Sole proprietorNo
NPI enumeratedApril 19, 2012
Last updated in NPPESApril 19, 2012

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