Provider Demographics
NPI:1982404281
Name:TRIESKEY, JENNIFER LYNN (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:TRIESKEY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:SUGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 ROXBORO ST
Mailing Address - Street 2:
Mailing Address - City:HAW RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:27258-9631
Mailing Address - Country:US
Mailing Address - Phone:919-428-4465
Mailing Address - Fax:
Practice Address - Street 1:302 W GRAHAM ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-2312
Practice Address - Country:US
Practice Address - Phone:919-568-0004
Practice Address - Fax:919-355-9032
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC226867163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice