Provider Demographics
NPI:1447501333
Name:JUMP, PAMELA JEAN (APRN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:JUMP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890631
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0631
Mailing Address - Country:US
Mailing Address - Phone:812-949-5582
Mailing Address - Fax:812-949-5966
Practice Address - Street 1:1713 E 10TH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-7100
Practice Address - Country:US
Practice Address - Phone:812-949-5575
Practice Address - Fax:812-949-5966
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004141A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner