Provider Demographics
NPI:1952700379
Name:CRIBBS, JAMIE MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MARIE
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MARIE
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4744 ASHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-4016
Mailing Address - Country:US
Mailing Address - Phone:951-805-3680
Mailing Address - Fax:
Practice Address - Street 1:4744 ASHFIELD DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-4016
Practice Address - Country:US
Practice Address - Phone:951-805-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0202234163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse