Provider Demographics
NPI:1386275758
Name:VEST, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:VEST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 14TH ST NW APT 21
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2739
Mailing Address - Country:US
Mailing Address - Phone:434-373-5153
Mailing Address - Fax:
Practice Address - Street 1:207 14TH ST NW APT 21
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2739
Practice Address - Country:US
Practice Address - Phone:434-373-5153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator