Provider Demographics
NPI:1669594073
Name:JAMISON, CAROL ANN (NMD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:JAMISON
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 E KROLL DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-4645
Mailing Address - Country:US
Mailing Address - Phone:480-449-7960
Mailing Address - Fax:480-836-0121
Practice Address - Street 1:17007 E COLONY DR STE 102
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-4672
Practice Address - Country:US
Practice Address - Phone:480-836-4411
Practice Address - Fax:480-836-0121
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04801175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath