Provider Demographics
NPI:1326322090
Name:LAPORTE, JAMIE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANN
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ANN
Other - Last Name:REMALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3317 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1436
Mailing Address - Country:US
Mailing Address - Phone:610-750-7894
Mailing Address - Fax:610-750-7896
Practice Address - Street 1:3317 PENN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1436
Practice Address - Country:US
Practice Address - Phone:610-750-7894
Practice Address - Fax:610-750-7896
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055131363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA055131OtherPA STATE LICENSE