Provider Demographics
NPI:1518409713
Name:JOSEY, JAIME
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:JOSEY
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 1:1973 CHICKEN RD
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31022-2643
Mailing Address - Country:US
Mailing Address - Phone:478-595-1119
Mailing Address - Fax:
Practice Address - Street 1:815 LEGION DR
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6782
Practice Address - Country:US
Practice Address - Phone:478-374-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-06
Last Update Date:2016-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN088046164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse