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Individual

JASON YARBROUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
534 TOWN ST, MOODUS, CT 06469-1101
(860) 873-1455
Mailing address
PO BOX 719, MOODUS, CT 06469-0719

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
162225
REGISTERED NURSE LICENSE NUMBER
CT
Enumeration date
08/24/2021
Last updated
09/09/2021
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