Provider Demographics
NPI:1811267610
Name:HAYMON, JESSICA
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:HAYMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CATAMARAN RD
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-2505
Mailing Address - Country:US
Mailing Address - Phone:928-750-6868
Mailing Address - Fax:
Practice Address - Street 1:2994 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-8738
Practice Address - Country:US
Practice Address - Phone:252-672-8680
Practice Address - Fax:252-638-6989
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7097235Z00000X
NC14628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ643265Medicare PIN