Provider Demographics
NPI:1245889443
Name:SLUMP, JAMIE RENEE' (FNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:RENEE'
Last Name:SLUMP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6901
Mailing Address - Country:US
Mailing Address - Phone:912-356-3170
Mailing Address - Fax:
Practice Address - Street 1:1006 FORDING ISLAND RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4869
Practice Address - Country:US
Practice Address - Phone:843-815-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN158893363LF0000X
SC27229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003225048AMedicaid