Provider Demographics
NPI:1477698868
Name:JAMO-PLACE, PATRICIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:JAMO-PLACE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:R
Other - Last Name:JAMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1301 REID ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3237
Mailing Address - Country:US
Mailing Address - Phone:386-328-5437
Mailing Address - Fax:386-328-5464
Practice Address - Street 1:1301 REID ST
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3237
Practice Address - Country:US
Practice Address - Phone:386-328-5437
Practice Address - Fax:386-328-5464
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9194112363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308288100Medicaid