Individual
AMANDA JAKUBOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 E BELT LINE RD STE D, COPPELL, TX 75019-9606
(972) 393-8687
(972) 393-8687
Mailing address
1705 E BELT LINE RD, COPPELL, TX 75019-9606
(972) 393-8687
(972) 393-4975
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP145528
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424394101
—
TX
01
—
AP145528
LICENSE NUMBER
TX
Enumeration date
03/05/2015
Last updated
07/06/2021
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