Individual
MARCIA ANN JAMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2530 S TELSHOR BLVD, SUITE 207, LAS CRUCES, NM 88011-4951
(575) 522-6806
(575) 521-8033
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
(575) 556-5960
(575) 556-5959
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
93-PA03
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000097651
—
NM
01
—
P00905170
RR MEDICARE
NM
Enumeration date
03/21/2007
Last updated
11/17/2016
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