Provider Demographics
NPI:1467856773
Name:BARTLETT, JAMIE (MSN, APRN, FNP, CCRN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP, CCRN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 3366
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3366
Mailing Address - Country:US
Mailing Address - Phone:812-386-6650
Mailing Address - Fax:
Practice Address - Street 1:685 VAIL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-9510
Practice Address - Country:US
Practice Address - Phone:812-386-6650
Practice Address - Fax:812-386-6698
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005184A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201315440Medicaid
IN201315440Medicaid