Provider Demographics
NPI:1881300655
Name:ARCHER, JAMIE LUVINA (NP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LUVINA
Last Name:ARCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LUVINA
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1390 US HIGHWAY 61 STE N1500
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4137
Mailing Address - Country:US
Mailing Address - Phone:636-933-5055
Mailing Address - Fax:636-933-3609
Practice Address - Street 1:1390 US HIGHWAY 61 STE N1500
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4137
Practice Address - Country:US
Practice Address - Phone:636-933-5055
Practice Address - Fax:636-933-3609
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOAG10200184363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology