Provider Demographics
NPI:1043373319
Name:FIELDS, JAYNE METZGER (M AUD CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:METZGER
Last Name:FIELDS
Suffix:
Gender:F
Credentials:M AUD CCC-A
Other - Prefix:MS
Other - First Name:JAYNE
Other - Middle Name:WINIFRED
Other - Last Name:METZGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAUD CCC-A
Mailing Address - Street 1:3701 BELLEMEADE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0137
Mailing Address - Country:US
Mailing Address - Phone:812-479-1411
Mailing Address - Fax:812-437-2636
Practice Address - Street 1:3701 BELLEMEADE AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0137
Practice Address - Country:US
Practice Address - Phone:812-479-1411
Practice Address - Fax:812-437-2636
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002227A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000218491OtherANTHEM BC AND BS
IN000000218491OtherANTHEM BC AND BS