MEDICARE: MRS. JAMIE GIVENS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024167379	VA
2	363LF0000X	Family Nurse Practitioner	12007	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871634428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAMIE GIVENS NP

Provider Business Mailing Address
First Line	:	1021 W OAKLAND AVE STE 310
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2192
Country	:	US
Telephone Number	:	423-952-2111
Fax Number	:	423-230-4669

Provider Business Practice Location Address
First Line	:	2204 PAVILION DR STE 310
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37660-4653
Country	:	US
Telephone Number	:	423-230-4660
Fax Number	:	423-230-4669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	12/29/2025

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