Healthcare Provider Details

I. General information

NPI: 1619352424
Provider Name (Legal Business Name): JAYMIE LYNN VERNOOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PRINCE ST
CARRBORO NC
27510-2218
US

IV. Provider business mailing address

149 BLUE BUTTERFLY DR
ANGIER NC
27501-5136
US

V. Phone/Fax

Practice location:
  • Phone: 989-600-2497
  • Fax:
Mailing address:
  • Phone: 919-758-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number11070
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: