Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 24367 | MD |
N | 207VX0201X | Gynecologic Oncologist | 301195 | LA |
Y | 207VX0201X | Gynecologic Oncologist | 35.121409 | OH |
NPI | 1275777682 |
---|---|
Provider Name | Dr. Amelia Marie Jernigan |
First Address | New Orleans, LA 70112-2865 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2009 |
Last Update Date | 11/01/2021 |