Provider Demographics
NPI:1326210881
Name:DUEHRING, JESSICA (MPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DUEHRING
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12830
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2830
Mailing Address - Country:US
Mailing Address - Phone:252-636-9800
Mailing Address - Fax:252-636-1945
Practice Address - Street 1:122 BRANCHWOOD SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5800
Practice Address - Country:US
Practice Address - Phone:910-938-7555
Practice Address - Fax:910-938-7544
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2504160Medicare PIN