Healthcare Provider Details

I. General information

NPI: 1013303031
Provider Name (Legal Business Name): ABBEY MARIE JAMISON LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBEY MARIE BAMFORD

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 CLINCH AVE 2ND FLOOR SOUTH TOWER
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-525-1425
  • Fax: 877-935-4221
Mailing address:
  • Phone: 865-541-8895
  • Fax: 865-633-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number35
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: