| Doctor Name: | JAMIE BIRGE |
| NPI Number: | 1023480944 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R881801 |
| Business Practice Address: | 643 W Service Dr Coldwater, MS - 386183822 |
| Business Phone Number: | 6626244292 |
| Business Fax Number: | 6626244354 |
| Mailing Address: | 510 Highway 322, P O Box 1216 CLARKSDALE |
| State: | MS |
| Postal Code: | 386144717 |
| Phone Number: | 6626244292 |
| Fax Number: | 6626244354 |
| NPI Enumeration Date: | 10/30/2015 |
| NPI Last Update Date: | 10/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R881801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |