# JAMIE SHARI LANDRETH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518131945
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA-336 | AR | — |
| 363A00000X | Physician Assistant | PA06337 | TX | Yes |

## Other

- **Enumeration date:** 04/16/2008
- **Last updated:** 05/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1F4890 | MEDICARE | TX |
| 05 | — | 200263770A | — | OK |
| 01 | — | P02599453 | RR MCR | TX |
| 01 | — | PA-336 | LICENSE \# | AR |
| 01 | — | PA06337 | STATE LICENSE | TX |