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1568930113
BEENA JACOB
RALEIGH, NC
NPI
1568930113
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 5011196)
Enumeration Date
2018-11-12
Last Update Date
2018-11-12
Business Address
BEENA JACOB
4505 FAIR MEADOWS LN STE 101
RALEIGH, NC 27607-6449
Phone number: 919-787-4000
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Mailing Address
BEENA JACOB
23 FINISH LINE RD
BAHAMA, NC 27503-9657
Phone number: 919-479-6785
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