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General NPI Number Information
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NPI Number | 1033978648
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Entity Type | Individual
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Provider Name | JAMIE FLYTHE
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 2704 N OAK ST BLDG C2
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City | VALDOSTA
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State | GA
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Zip | 31602-1795
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Country | US
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Telephone | 229-474-6933
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Fax | 888-815-1851
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Provider Business Mailing Address
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Address Line | 13364 BEACH BLVD UNIT 409
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN291974
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 9582156
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11032352
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License Number State | FL
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