Provider Demographics
NPI:1083087035
Name:TABB, JAMIE NICOLE (MSN, RN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NICOLE
Last Name:TABB
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Gender:F
Credentials:MSN, RN, CRNP
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Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:CHOP WOOD AMBULATORY CARE BLDG, 1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:215-590-2208
Mailing Address - Fax:267-426-2950
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHOP WOOD AMBULATORY CARE BLDG, 1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-2208
Practice Address - Fax:267-426-2950
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2016-09-27
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Provider Licenses
StateLicense IDTaxonomies
PASP014864363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics