Provider Demographics
NPI:1780032672
Name:SUGG, JILLIAN NYSWONGER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:NYSWONGER
Last Name:SUGG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:CLAIRE
Other - Last Name:NYSWONGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:PO BOX 3887
Mailing Address - Street 2:DEPT OF SPEECH PATHOLOGY & AUDIOLOGY- DUMC
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-6271
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR
Practice Address - Street 2:DEPT OF SPEECH PATHOLOGY & AUDIOLOGY, DUMC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4000
Practice Address - Country:US
Practice Address - Phone:919-684-6271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist