MEDICARE: JAMIE ANN LILIE CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	201908210NP-PP	OR
2	363LA2200X	Adult Health Nurse Practitioner	SP011666	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225313943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE ANN LILIE CRNP

Provider Business Mailing Address
First Line	:	3141 CAPE HORN RD
Second Line	:
City	:	RED LION
State	:	PA
Zip	:	17356-9071
Country	:	US
Telephone Number	:	717-246-5180
Fax Number	:	717-246-2005

Provider Business Practice Location Address
First Line	:	3141 CAPE HORN RD
Second Line	:
City	:	RED LION
State	:	PA
Zip	:	17356-9071
Country	:	US
Telephone Number	:	717-246-5180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2011
Last Update Date	:	11/12/2025

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