Provider Demographics
NPI:1770281297
Name:CORWIN, JAMIE ALICE (DNP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ALICE
Last Name:CORWIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:64 PICKWICK CT
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2712
Mailing Address - Country:US
Mailing Address - Phone:406-253-8924
Mailing Address - Fax:
Practice Address - Street 1:70 VILLAGE LOOP RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2793
Practice Address - Country:US
Practice Address - Phone:406-752-8877
Practice Address - Fax:406-756-3245
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-213150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily