Provider Demographics
NPI:1528414158
Name:SHELDON, JAMIE NOELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:NOELLE
Last Name:SHELDON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3642 BEARD RD
Mailing Address - Street 2:APARTMENT G
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-6731
Mailing Address - Country:US
Mailing Address - Phone:910-587-4873
Mailing Address - Fax:
Practice Address - Street 1:3007 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-3662
Practice Address - Country:US
Practice Address - Phone:910-354-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06434363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant