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Individual

MS. DALLARIE JAMISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
201 REGENCY CT, DOTHAN, AL 36305-1179
(334) 673-8869
(334) 673-8851
Mailing address
PO BOX 8308, DOTHAN, AL 36304-0308
(334) 673-8869
(334) 673-8851

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9475102
FL
2084P0800X
Psychiatry Physician
Primary
CP.17240
AL
2084P0800X
Psychiatry Physician
RN209490
GA
2084P0805X
Geriatric Psychiatry Physician
1-127798
AL
2084P0805X
Geriatric Psychiatry Physician
9475102
FL
2084P0805X
Geriatric Psychiatry Physician
RN209490
GA
363L00000X
Nurse Practitioner
1-127798
AL
363L00000X
Nurse Practitioner
9475102
FL
363L00000X
Nurse Practitioner
RN209490
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003194200C
GA
05
010838800
AL
05
010838800
FL
01
0348462
CIGNA
01
1013117167
NPI
01
1080690
BEACON
01
1083079453
NPI
01
13804050
CAQH
05
188102
AL
01
19C1R
NEW DIRECTIONS
05
205760
AL
05
229432
AL
05
407098142C
GA
01
51521565
BCBS
AL
01
523314
VALUE OPTIONS
01
601701400
DOL
01
774089000
MAGELLAN
01
Q6YNL
FLORIDA BLUE
Enumeration date
12/29/2015
Last updated
05/22/2019
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