Provider Demographics
NPI:1881938926
Name:WILES, JAMIE LEE (RN, MHNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:WILES
Suffix:
Gender:F
Credentials:RN, MHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 GATEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4820
Mailing Address - Country:US
Mailing Address - Phone:336-823-6948
Mailing Address - Fax:
Practice Address - Street 1:206 GATEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4820
Practice Address - Country:US
Practice Address - Phone:336-823-6948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50122882084A0401X, 363LP0808X
MI4704280936363LP0808X
OH14085.APRN363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine