Provider Demographics
NPI:1386229078
Name:CLEMENT, JAMIE MICHELE (APN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LONGLEAF LN
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1630 ROUTE 322 UNIT A
Practice Address - Street 2:
Practice Address - City:WOOLWICH TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08085-3701
Practice Address - Country:US
Practice Address - Phone:856-832-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01101900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health