Provider Demographics
NPI:1801294954
Name:SIKORA, JAMIE M (APN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:SIKORA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WOODFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LOGAN TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1855
Mailing Address - Country:US
Mailing Address - Phone:856-885-3366
Mailing Address - Fax:
Practice Address - Street 1:831 KINGS HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096
Practice Address - Country:US
Practice Address - Phone:856-853-8730
Practice Address - Fax:856-853-8870
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00535300363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner