Jacob Mayberry, AS-C is a
Clinical Nurse Specialist based in Bridgeport, Texas. Jacob Mayberry is licensed to practice in Texas (license number TC08-0326A) and his current practice location is
104 Blue Water Dr, Bridgeport, Texas. He can be reached at his office (for appointments etc.) via phone at
(940) 683-8078.
NPI number for Jacob Mayberry is 1437311081 and his current mailing address is 104 Blue Water Dr, Bridgeport, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1437311081.
Provider's Profile
| Full Name | Jacob Mayberry |
|---|
| Gender | Male |
|---|
| Speciality | Clinical Nurse Specialist |
|---|
| Location | 104 Blue Water Dr, Bridgeport, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1437311081
- Provider Enumeration Date: 06/25/2008
- Last Update Date: 06/25/2008
Medical Identifiers
Medical identifiers for Jacob Mayberry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437311081 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 364S00000X | Clinical Nurse Specialist | TC08-0326A (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Mayberry is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacob Mayberry, AS-C
104 Blue Water Dr,
Bridgeport, TX 76426-4336
Ph: (940) 683-8078 | Jacob Mayberry, AS-C
104 Blue Water Dr,
Bridgeport, TX 76426-4336
Ph: (940) 683-8078 |
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