Provider Demographics
NPI:1063642130
Name:RUBIO, JESSICA ANNA (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNA
Last Name:RUBIO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N GRAHAM HOPEDALE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-2971
Mailing Address - Country:US
Mailing Address - Phone:336-570-3739
Mailing Address - Fax:336-570-1215
Practice Address - Street 1:221 N GRAHAM HOPEDALE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2971
Practice Address - Country:US
Practice Address - Phone:336-570-3739
Practice Address - Fax:336-570-1215
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251651363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care