Provider Demographics
NPI:1972616944
Name:JAMIESON, ANNA LLEWELLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LLEWELLYN
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-2802
Mailing Address - Country:US
Mailing Address - Phone:919-734-8604
Mailing Address - Fax:
Practice Address - Street 1:400 N WILLIAM ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2802
Practice Address - Country:US
Practice Address - Phone:919-734-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905503Medicaid
NC143HYOtherBCBS
NCI73501Medicare UPIN
NC5905503Medicaid