Provider Demographics
NPI:1144574252
Name:YACOUB, JOCELYN (RPH)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:YACOUB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16257 E OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3057
Mailing Address - Country:US
Mailing Address - Phone:720-987-3751
Mailing Address - Fax:
Practice Address - Street 1:17031 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3161
Practice Address - Country:US
Practice Address - Phone:720-851-7754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist