Provider Demographics
NPI:1477115343
Name:LICHTSINN, JAMIE LEANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEANN
Last Name:LICHTSINN
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:1 DOT WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:62353-1664
Mailing Address - Country:US
Mailing Address - Phone:217-773-4411
Mailing Address - Fax:217-773-9452
Practice Address - Street 1:1 DOT WAY
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:IL
Practice Address - Zip Code:62353-1664
Practice Address - Country:US
Practice Address - Phone:217-773-4411
Practice Address - Fax:217-773-9452
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41.421346163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health