Individual
JACOB P BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
501 SUNSET LN, CULPEPER, VA 22701-3917
(540) 829-4100
(540) 829-4392
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0024189256
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024189256
VA
Other
Enumeration date
05/28/2024
Last updated
08/14/2024
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