Provider Demographics
NPI:1689724452
Name:ATKINSON, JAMIE RENEE
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:RENEE
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 E MONTEROSA ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3049
Mailing Address - Country:US
Mailing Address - Phone:480-970-1437
Mailing Address - Fax:
Practice Address - Street 1:6311 E MONTEROSA ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3049
Practice Address - Country:US
Practice Address - Phone:480-970-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0273A225200000X
AZ0273225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant