Provider Demographics
NPI:1811560303
Name:MANCUSO, JAMIE (MSN, RN, CPNP-PC)
Entity Type:Individual
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First Name:JAMIE
Middle Name:
Last Name:MANCUSO
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Gender:F
Credentials:MSN, RN, CPNP-PC
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Mailing Address - Street 1:100 DUKE HEALTH CARY PL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6759
Mailing Address - Country:US
Mailing Address - Phone:919-385-4650
Mailing Address - Fax:
Practice Address - Street 1:100 DUKE HEALTH CARY PL
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6759
Practice Address - Country:US
Practice Address - Phone:919-385-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCMANC-9E5W8363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics