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Individual

GERHARD HEINZ JAKUBOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN , BSN, CFRN

Contact information

Practice address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6000
Mailing address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6000

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN104727
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020529
AZ
Enumeration date
09/29/2017
Last updated
09/29/2017
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