Provider Demographics
NPI:1235746611
Name:DIAMOND, JAMIE KATE (NP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:KATE
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BIRDNECK CIR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5516
Mailing Address - Country:US
Mailing Address - Phone:757-385-6910
Mailing Address - Fax:757-437-4710
Practice Address - Street 1:409 BIRDNECK CIR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-5516
Practice Address - Country:US
Practice Address - Phone:757-385-6910
Practice Address - Fax:757-437-4710
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179690363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health