Provider Demographics
NPI:1871948703
Name:FIELDS, JAYMIE J (DNP)
Entity type:Individual
Prefix:DR
First Name:JAYMIE
Middle Name:J
Last Name:FIELDS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:JAYMIE
Other - Middle Name:J
Other - Last Name:CULLENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:33 N CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 N CALHOUN ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-905-7456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001307944163W00000X
VA0024179428363LF0000X, 363LP0808X, 363LP0808X
MDAC002985363LF0000X
SC21518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1871948703Medicaid
NC1871948703Medicaid