Basic Information
| Provider Information | |||||||||
| NPI: | 1487135778 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOBE | ||||||||
| FirstName: | ABBY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1258 | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384851258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312531110 | ||||||||
| FaxNumber: | 9312531190 | ||||||||
| Practice Location | |||||||||
| Address1: | 519 CITY AVE S | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386632517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6625878206 | ||||||||
| FaxNumber: | 6625878207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2018 | ||||||||
| LastUpdateDate: | 08/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 902688 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.