Provider Demographics
NPI:1730719329
Name:LAYSON, JESSICA CLAIRE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CLAIRE
Last Name:LAYSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:CLAIRE
Other - Last Name:PERRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 OAK SHADOW WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-2985
Mailing Address - Country:US
Mailing Address - Phone:770-990-5811
Mailing Address - Fax:
Practice Address - Street 1:150 OAK SHADOW WAY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-2985
Practice Address - Country:US
Practice Address - Phone:770-990-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant