Provider Demographics
NPI:1104714732
Name:DRISCOLL, JAIME LOUISE (BSN, RN, CLNC)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LOUISE
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:BSN, RN, CLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 BOSQUE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-9532
Mailing Address - Country:US
Mailing Address - Phone:515-218-4285
Mailing Address - Fax:
Practice Address - Street 1:239 BOSQUE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-9532
Practice Address - Country:US
Practice Address - Phone:515-218-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57420163WC0400X, 163WC1500X, 163WH0200X, 173000000X, 2080C0008X, 163WP0200X, 251E00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No173000000XOther Service ProvidersLegal Medicine
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
No251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered Nurse