Provider Demographics
NPI:1033427695
Name:GILES, JAMIE MITCHELL (FNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MITCHELL
Last Name:GILES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 DUTCH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-5104
Mailing Address - Country:US
Mailing Address - Phone:865-435-6056
Mailing Address - Fax:
Practice Address - Street 1:1809 DUTCH VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-5117
Practice Address - Country:US
Practice Address - Phone:865-435-6056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000165533163WN0300X
TN15478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0300XNursing Service ProvidersRegistered NurseNephrology