Provider Demographics
NPI:1386002772
Name:DICKEY, JAMIE GOSS (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:GOSS
Last Name:DICKEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-426-1629
Mailing Address - Fax:770-427-8001
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 130
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-426-1629
Practice Address - Fax:770-427-8001
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN184687363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care