Healthcare Provider Details

I. General information

NPI: 1386315935
Provider Name (Legal Business Name): MRS. AMBER LYNN JAMISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E BROAD ST
RICHMOND VA
23219-1930
US

IV. Provider business mailing address

8407 FEDORA DR
CHESTERFIELD VA
23838-6256
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-2467
  • Fax: 804-628-5849
Mailing address:
  • Phone: 540-272-0568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024192001
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001274142
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: