Individual
JACLYN E TUBARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9430 PARK WEST BLVD STE 130, KNOXVILLE, TN 37923-4205
(865) 690-4861
(865) 560-8525
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(865) 243-8153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3795
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q055190
—
TN
Enumeration date
10/31/2011
Last updated
10/13/2023
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