Provider Demographics
NPI:1144859224
Name:OUBRE, JAMIE DANIELLE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:DANIELLE
Last Name:OUBRE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-8716
Mailing Address - Country:US
Mailing Address - Phone:706-577-2406
Mailing Address - Fax:
Practice Address - Street 1:5009 RIVERCHASE DR STE 500
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-7490
Practice Address - Country:US
Practice Address - Phone:334-448-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily