Provider Demographics
NPI:1558118612
Name:DYALS, JESSICA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:DYALS
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 LINDSEY LN STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-1656
Mailing Address - Country:US
Mailing Address - Phone:912-882-5030
Mailing Address - Fax:888-476-5235
Practice Address - Street 1:88 LINDSEY LN STE B
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-1656
Practice Address - Country:US
Practice Address - Phone:912-882-5030
Practice Address - Fax:888-476-5235
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine