Provider Demographics
NPI:1689961146
Name:ENGLAND, JAIME ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:ANN
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 296
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1066
Mailing Address - Country:US
Mailing Address - Phone:712-655-4433
Mailing Address - Fax:712-655-4434
Practice Address - Street 1:123 MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1066
Practice Address - Country:US
Practice Address - Phone:712-655-4433
Practice Address - Fax:712-655-4434
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004745225100000X
IA4745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1460023Medicare PIN