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Individual

JAMIE L PAIVA-SHARMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, AGACNP-BC

Contact information

Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10611
WI
363LA2100X
Acute Care Nurse Practitioner
10611-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100140187
WI
01
209.021018
ADVANCED PRACTICE REGISTERED NURSE
IL
01
309.016183
CONTROLLED SUBSTANCE LICENSE
IL
Enumeration date
09/10/2020
Last updated
12/12/2023
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