Provider Demographics
NPI:1689094351
Name:VARNER, JAIMEE GANDY (APRN)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:GANDY
Last Name:VARNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3326
Mailing Address - Country:US
Mailing Address - Phone:936-634-9233
Mailing Address - Fax:
Practice Address - Street 1:1222 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3326
Practice Address - Country:US
Practice Address - Phone:936-634-9233
Practice Address - Fax:936-634-9353
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX728067363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics