Provider Demographics
NPI:1356990642
Name:UPCHURCH, JAMIE R
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:R
Last Name:UPCHURCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3877 APRICOT CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-5905
Mailing Address - Country:US
Mailing Address - Phone:901-501-4946
Mailing Address - Fax:
Practice Address - Street 1:3877 APRICOT CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-5905
Practice Address - Country:US
Practice Address - Phone:901-501-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health