Provider Demographics
NPI:1720701170
Name:SHULER, JAMIE
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:SHULER
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 1:1013 SAINT AUGUSTINE PKWY
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-4351
Mailing Address - Country:US
Mailing Address - Phone:770-568-5018
Mailing Address - Fax:
Practice Address - Street 1:1013 SAINT AUGUSTINE PKWY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-4351
Practice Address - Country:US
Practice Address - Phone:770-568-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA485991Medicaid
GA62412Medicaid