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NPI Code Detail

MEDICARE: MS. JACQUELINE AUGSBURGER FNP-BC

MEDICARE: MS. JACQUELINE AUGSBURGER FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner5004265NC

General Provider Information

NPI Number : 1194967372
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELINE AUGSBURGER FNP-BC
Provider Business Mailing Address
First Line : 113 QUAILWOOD CIR
Second Line :
City : CAPE CARTERET
State : NC
Zip : 28584-9749
Country : US
Telephone Number : 252-393-6751
Fax Number :
Provider Business Practice Location Address
First Line : 317 WESTERN BLVD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6379
Country : US
Telephone Number : 910-577-2240
Fax Number : 910-577-2439
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2009
Last Update Date : 04/13/2015

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