Provider Demographics
NPI:1497132476
Name:LEGREE, JAMECIA
Entity Type:Individual
Prefix:
First Name:JAMECIA
Middle Name:
Last Name:LEGREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SW SYMPHONY LOOP
Mailing Address - Street 2:BLDG 15 APT 204
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025
Mailing Address - Country:US
Mailing Address - Phone:386-365-6420
Mailing Address - Fax:
Practice Address - Street 1:800 SW SYMPHONY LOOP
Practice Address - Street 2:BLDG 15 APT 204
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025
Practice Address - Country:US
Practice Address - Phone:386-365-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9404463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse