Provider Demographics
NPI:1689133365
Name:DENMARK, JAMIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:DENMARK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 COUNTY ROAD 497
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:AL
Mailing Address - Zip Code:35673-5369
Mailing Address - Country:US
Mailing Address - Phone:256-565-2110
Mailing Address - Fax:
Practice Address - Street 1:420 LOWELL DR SE STE 204
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3763
Practice Address - Country:US
Practice Address - Phone:256-536-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118378363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care