MEDICARE: AMY M JAMISON

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	133V00000X	Registered Dietitian	912535	CO

General Provider Information

NPI Number	:	1790965572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY M JAMISON

Provider Business Mailing Address
First Line	:	7417 BEAVER RUN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5103
Country	:	US
Telephone Number	:	970-389-4312
Fax Number	:

Provider Business Practice Location Address
First Line	:	7417 BEAVER RUN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5103
Country	:	US
Telephone Number	:	970-389-4312
Fax Number	:

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	05/22/2026

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Directions to “ AMY M JAMISON ” Practice Location

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