Provider Demographics
NPI:1316002967
Name:ATWOOD, JAMIE LYNN
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:HIGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 330
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-0330
Mailing Address - Country:US
Mailing Address - Phone:606-365-1547
Mailing Address - Fax:606-365-8380
Practice Address - Street 1:100 JAY ST
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-7511
Practice Address - Country:US
Practice Address - Phone:606-365-1547
Practice Address - Fax:606-365-8380
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4393P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78014081Medicaid