Provider Demographics
NPI:1225267735
Name:CORDES, JAMIE CHILES (APN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:CHILES
Last Name:CORDES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 ESSARY DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2468
Mailing Address - Country:US
Mailing Address - Phone:865-288-3754
Mailing Address - Fax:856-243-2250
Practice Address - Street 1:2911 ESSARY DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2468
Practice Address - Country:US
Practice Address - Phone:865-288-3754
Practice Address - Fax:865-243-2250
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2009006026363LF0000X
TN14293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517154Medicaid
TN103I508551Medicare PIN