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NPI Code Detail

MEDICARE: MS. MICHELE MARIA JARBEAU PA

MEDICARE: MS. MICHELE MARIA JARBEAU PA
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
1363A00000XPhysician Assistant102063NC

General Provider Information

NPI Number : 1932194503
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELE MARIA JARBEAU PA
Provider Business Mailing Address
First Line : 991 W HUDSON BLVD
Second Line :
City : GASTONIA
State : NC
Zip : 28052-6430
Country : US
Telephone Number : 704-853-5079
Fax Number : 704-853-5269
Provider Business Practice Location Address
First Line : 991 W HUDSON BLVD
Second Line :
City : GASTONIA
State : NC
Zip : 28052-6430
Country : US
Telephone Number : 704-853-5079
Fax Number : 704-853-5269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 07/08/2007

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Directions to “ MS. MICHELE MARIA JARBEAU PA” Practice Location

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