Provider Demographics
NPI:1558644674
Name:CHILES, JAMIE LYNN (ANP)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LYNN
Last Name:CHILES
Suffix:
Gender:F
Credentials:ANP
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Mailing Address - Street 1:451 HEALTH PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-8242
Mailing Address - Country:US
Mailing Address - Phone:269-655-3080
Mailing Address - Fax:269-655-0761
Practice Address - Street 1:451 HEALTH PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-8242
Practice Address - Country:US
Practice Address - Phone:269-655-3080
Practice Address - Fax:269-655-0761
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2014-11-13
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Provider Licenses
StateLicense IDTaxonomies
MI4704194440363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care