Provider Demographics
NPI:1427257773
Name:MCDONALD, JAMIE MITCHELL (APRN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MITCHELL
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAMUEL Y BROWN PEDIATRICS
Mailing Address - Street 2:3813 WILLIAMS BLVD
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065
Mailing Address - Country:US
Mailing Address - Phone:504-443-5437
Mailing Address - Fax:
Practice Address - Street 1:SAMUEL Y BROWN PEDIATRICS
Practice Address - Street 2:3813 WILLIAMS BLVD
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:504-443-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily