Provider Demographics
NPI:1619167509
Name:KANE, JAMIE LYNN (RCP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:KANE
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 E PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3318
Mailing Address - Country:US
Mailing Address - Phone:602-326-1106
Mailing Address - Fax:
Practice Address - Street 1:12080 SW 127TH AVE
Practice Address - Street 2:113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6454
Practice Address - Country:US
Practice Address - Phone:786-853-9810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ57302278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health