Provider Demographics
NPI:1710319363
Name:ROY, JAIME ALEXANDRA (PA-C)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:ALEXANDRA
Last Name:ROY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5698
Mailing Address - Fax:
Practice Address - Street 1:127 VANCE HILL DR
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-4996
Practice Address - Country:US
Practice Address - Phone:828-890-3883
Practice Address - Fax:828-890-3100
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04399363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCI611FOtherMEDICARE PTAN
NCNCI611EOtherMEDICARE PTAN
NCNCI611AOtherMEDICARE PTAN
NCNCI611COtherMEDICARE PTAN
NCNCI611BOtherMEDICARE PTAN
NCNCI611DOtherMEDICARE PTAN