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General NPI Number Information
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NPI Number | 1780018002
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Entity Type | Individual
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Provider Name | BRENDA SUE JAMISON LPN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 35 GUERNSEY ST
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City | NORWICH
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State | NY
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Zip | 13815-1326
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Country | US
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Telephone | 607-376-3269
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Fax |
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Provider Business Mailing Address
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Address Line | 889 COUNTY ROAD 38
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City | BAINBRIDGE
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State | NY
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Zip | 13733-3171
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Country | US
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Telephone | 607-376-3269
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 242162
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License Number State | NY
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