Provider Demographics
NPI:1104424688
Name:ASMUSSEN, JAMIE CARLENE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:CARLENE
Last Name:ASMUSSEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28145 FLORENCE LN
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3817
Mailing Address - Country:US
Mailing Address - Phone:661-373-2092
Mailing Address - Fax:
Practice Address - Street 1:2271 E PALMDALE BLVD STE E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-1340
Practice Address - Country:US
Practice Address - Phone:661-538-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily