Provider Demographics
NPI:1992318836
Name:DAMPIER, JASMINE (CERTIFICATION)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:DAMPIER
Suffix:
Gender:F
Credentials:CERTIFICATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14580 SW ESPERANZA CT
Mailing Address - Street 2:
Mailing Address - City:INDIANTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:34956-3902
Mailing Address - Country:US
Mailing Address - Phone:772-240-3979
Mailing Address - Fax:
Practice Address - Street 1:14580 SW ESPERANZA CT
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956-3902
Practice Address - Country:US
Practice Address - Phone:772-240-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLX6S8B5Z6372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion