Provider Demographics
NPI:1396432928
Name:JAYNES, DAVID AUSTIN (EMT-P)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:AUSTIN
Last Name:JAYNES
Suffix:
Gender:M
Credentials:EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 BECKER AVE NW
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2101
Mailing Address - Country:US
Mailing Address - Phone:828-448-1662
Mailing Address - Fax:
Practice Address - Street 1:337 BECKER AVE NW
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2101
Practice Address - Country:US
Practice Address - Phone:828-448-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP109772146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic