Provider Demographics
NPI:1326789488
Name:STICKLER, JAMIE MICHELLE (APRN, PMHNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:STICKLER
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MICHELLE
Other - Last Name:ROTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 CITI CTR ST # 1116
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3425
Mailing Address - Country:US
Mailing Address - Phone:844-968-9355
Mailing Address - Fax:
Practice Address - Street 1:1239 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830
Practice Address - Country:US
Practice Address - Phone:844-968-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110016868363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health