Healthcare Provider Details

I. General information

NPI: 1568327732
Provider Name (Legal Business Name): HIGHLANDS HOME PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25139 HILLMAN HWY
ABINGDON VA
24210-7603
US

IV. Provider business mailing address

25139 HILLMAN HWY
ABINGDON VA
24210-7603
US

V. Phone/Fax

Practice location:
  • Phone: 276-378-6344
  • Fax:
Mailing address:
  • Phone: 276-378-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMIE RAY ANDERSON
Title or Position: OWNER/PROVIDER/NURSE PRACTITIONER
Credential: AGPCNP-BC
Phone: 276-378-6344