Provider Demographics
NPI:1871948703
Name:FIELDS, JAYMIE J (DNP)
Entity type:Individual
Prefix:DR
First Name:JAYMIE
Middle Name:J
Last Name:FIELDS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:JAYMIE
Other - Middle Name:J
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:9480 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4032
Mailing Address - Country:US
Mailing Address - Phone:412-722-9471
Mailing Address - Fax:
Practice Address - Street 1:9480 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4032
Practice Address - Country:US
Practice Address - Phone:571-445-0441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179428363LF0000X, 363LP0808X, 363LP0808X
MDAC002985363LF0000X
MDAC006488363LP0808X
VA0001307944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1871948703Medicaid
NC1871948703Medicaid