Provider Demographics
NPI:1992326946
Name:RATES, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:RATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9790 DALEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-9108
Mailing Address - Country:US
Mailing Address - Phone:313-461-1869
Mailing Address - Fax:
Practice Address - Street 1:9790 DALEVIEW DR
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-9108
Practice Address - Country:US
Practice Address - Phone:313-461-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704311619163W00000X, 363LA2100X
MI2020037427363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse