Healthcare Provider Details

I. General information

NPI: 1053832998
Provider Name (Legal Business Name): JACLYN MARIE JASKULKA AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACLYN MARIE ROWLETT AU.D.

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 NEUSE BLVD STE H
NEW BERN NC
28560-4318
US

IV. Provider business mailing address

2111 NEUSE BLVD STE H
NEW BERN NC
28560-4318
US

V. Phone/Fax

Practice location:
  • Phone: 833-354-1492
  • Fax:
Mailing address:
  • Phone: 833-354-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30002438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: