Provider Demographics
NPI:1265324412
Name:MCDONALD, JAMIE DANIELLE (OA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DANIELLE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:OA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WALLACE AVE APT 6A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-3169
Mailing Address - Country:US
Mailing Address - Phone:910-359-6348
Mailing Address - Fax:
Practice Address - Street 1:600 WALLACE AVE APT 6A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-3169
Practice Address - Country:US
Practice Address - Phone:910-359-6348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare