Provider Demographics
NPI:1508611385
Name:DAVISON-ORTIZ, JAMIE T
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:T
Last Name:DAVISON-ORTIZ
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 1:1208 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1216
Mailing Address - Country:US
Mailing Address - Phone:512-888-1003
Mailing Address - Fax:
Practice Address - Street 1:1208 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1216
Practice Address - Country:US
Practice Address - Phone:512-888-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula