Individual
JILLIAN SARA TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
924 N HOWE ST, SOUTHPORT, NC 28461-3099
(910) 454-1192
Mailing address
3504 E PELICAN DR, OAK ISLAND, NC 28465-5853
(910) 619-7836
(877) 807-7381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5019704
NC
Other
Enumeration date
03/01/2024
Last updated
07/10/2024
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