Individual provider · Type 1 NPI
Johanna Green-Jacob, NURSE PRACTITIONER
Family Nurse Practitioner · San Diego, CA
NPI number
1609863968
Active
Practice location
823 Gateway Center Way
San Diego, CA 92102-4541
Fax (619) 906-4564
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 13014 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1609863968
Johanna Green-Jacob, NURSE PRACTITIONER's National Provider Identifier is 1609863968, issued on Oct 3, 2005. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Diego, CA. The record was last updated on Feb 25, 2014.