=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932531183
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARCELA JAOKO APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2013
-----------------------------------------------------
Last Update Date | 03/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9705 TEHAMA RIDGE PKWY STE A238
-----------------------------------------------------
City | FORT WORTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76177-7507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-703-9027
-----------------------------------------------------
Fax | 699-332-0734
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 528
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76262-0528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-703-9027
-----------------------------------------------------
Fax | 469-933-2073
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP140374
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------