Provider Demographics
NPI:1225343445
Name:JAMISON, TERRI LEE (RN)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LEE
Last Name:JAMISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SOUTH ST
Mailing Address - Street 2:UPPER
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-1202
Mailing Address - Country:US
Mailing Address - Phone:585-768-8928
Mailing Address - Fax:
Practice Address - Street 1:30 SOUTH ST
Practice Address - Street 2:UPPER
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-1202
Practice Address - Country:US
Practice Address - Phone:585-768-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY495428-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse