Provider Demographics
NPI:1538477369
Name:SATHER, JAIME LYNN (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNN
Last Name:SATHER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 SECLUSION DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-6974
Mailing Address - Country:US
Mailing Address - Phone:479-320-7707
Mailing Address - Fax:
Practice Address - Street 1:66 E MAIN ST # 303
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5008
Practice Address - Country:US
Practice Address - Phone:888-815-3583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1566187163WP0808X
MN4450363LP0808X, 363LP0808X
FL11006978363LP0808X, 363LP0808X
FLARNP 9312368363LP0808X
GARN243632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS861ZOtherMEDICARE PTAN
FL008732000Medicaid
FL002798300Medicaid