Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 251651 | NC |
NPI | 1063642130 |
---|---|
Provider Name | Jessica Anna Rubio |
First Address | Burlington, NC 27217-2971 |
Second Address | Burlington, NC 27217-2971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 11/11/2013 |