Provider Demographics
NPI:1891261277
Name:NORMAN, JAMIE (PA-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:NORMAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6142 SHALLOWFORD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7216
Mailing Address - Country:US
Mailing Address - Phone:423-498-3300
Mailing Address - Fax:
Practice Address - Street 1:6142 SHALLOWFORD RD STE 103
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7216
Practice Address - Country:US
Practice Address - Phone:423-498-3300
Practice Address - Fax:423-498-3301
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3725363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical