Individual
MISS TOMASITA RIVERA JACUBOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2500 SUMMIT AVE, GREENSBORO, NC 27405-4522
(336) 621-2500
(336) 478-2541
Mailing address
2500 SUMMIT AVE, GREENSBORO, NC 27405-4522
(336) 621-2500
(336) 478-2541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
600034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004004
—
NC
Enumeration date
10/18/2006
Last updated
12/18/2012
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