Provider Demographics
NPI:1891593984
Name:MYRICK, JADYN MYCHAL
Entity type:Individual
Prefix:
First Name:JADYN
Middle Name:MYCHAL
Last Name:MYRICK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RYANS WAY LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27537-3401
Mailing Address - Country:US
Mailing Address - Phone:252-915-0853
Mailing Address - Fax:
Practice Address - Street 1:16 RYANS WAY LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-3401
Practice Address - Country:US
Practice Address - Phone:252-915-0853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program