Healthcare Provider Details

I. General information

NPI: 1134067093
Provider Name (Legal Business Name): AMY L JUERGENS MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6085 NC 8 HWY S
GERMANTON NC
27019-8271
US

IV. Provider business mailing address

100 COURTHOUSE CIR
DANBURY NC
27016-7600
US

V. Phone/Fax

Practice location:
  • Phone: 336-591-7204
  • Fax:
Mailing address:
  • Phone: 336-536-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9441
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: