Individual
MS. JADE CARBOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AG05180071
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
104418853
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500761101
—
OR
Enumeration date
05/24/2018
Last updated
04/07/2024
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