Provider Demographics
NPI:1619614757
Name:DEEM, JAMIE SMITH (NP-C)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:SMITH
Last Name:DEEM
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 PAGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-8986
Mailing Address - Country:US
Mailing Address - Phone:336-212-0498
Mailing Address - Fax:
Practice Address - Street 1:2879 PAGETOWN RD
Practice Address - Street 2:
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244-8986
Practice Address - Country:US
Practice Address - Phone:336-212-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAG06210242363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care