Provider Demographics
NPI:1871847756
Name:DUKE UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:DUKE UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TUMBLESON
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:919-830-8725
Mailing Address - Street 1:DUMC 3540
Mailing Address - Street 2:TRENT DRIVE
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-3978
Mailing Address - Fax:
Practice Address - Street 1:DUMC 3540
Practice Address - Street 2:TRENT DRIVE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-684-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty