Provider Demographics
NPI:1306126529
Name:NORRELL, JAIMI MARIE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JAIMI
Middle Name:MARIE
Last Name:NORRELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 ALEXIS WAY
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-5416
Mailing Address - Country:US
Mailing Address - Phone:478-986-0688
Mailing Address - Fax:
Practice Address - Street 1:794 MCDONOUGH RD
Practice Address - Street 2:111
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-1572
Practice Address - Country:US
Practice Address - Phone:470-251-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN154709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily