Provider Demographics
NPI:1154794915
Name:ABRAHAM, JAYA SABU (APN-FNP)
Entity type:Individual
Prefix:MRS
First Name:JAYA
Middle Name:SABU
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:APN-FNP
Other - Prefix:MRS
Other - First Name:JAYAMOL
Other - Middle Name:
Other - Last Name:SABU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-FNP
Mailing Address - Street 1:101 E RIDGE ROAD
Mailing Address - Street 2:RIOGRANDE REGIONAL HOSPITAL
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-632-6000
Mailing Address - Fax:
Practice Address - Street 1:101 EAST RIDGE ROAD
Practice Address - Street 2:RIOGRANDE REGIONAL HOSPITAL
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-632-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124722363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner