Provider Demographics
NPI:1356401426
Name:HARRELSON, JAMIE LYNN (C-FNP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:MRS
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:HARRELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:C-FNP
Mailing Address - Street 1:10900 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3262
Mailing Address - Country:US
Mailing Address - Phone:303-307-2317
Mailing Address - Fax:
Practice Address - Street 1:10900 SMITH RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-3262
Practice Address - Country:US
Practice Address - Phone:303-307-2317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily