Provider Demographics
NPI:1497990378
Name:GERMAN, JAMIE VERONICA (LPN)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:VERONICA
Last Name:GERMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:VERONICA
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:100 LAKE TRAVERSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SISSETON
Mailing Address - State:SD
Mailing Address - Zip Code:57262
Mailing Address - Country:US
Mailing Address - Phone:605-698-7606
Mailing Address - Fax:605-742-0182
Practice Address - Street 1:100 LAKE TRAVERSE DR
Practice Address - Street 2:
Practice Address - City:SISSETON
Practice Address - State:SD
Practice Address - Zip Code:57262-7046
Practice Address - Country:US
Practice Address - Phone:605-698-7606
Practice Address - Fax:605-742-0182
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD-LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse