Provider Demographics
NPI:1851443303
Name:JARBOE, KATHLEEN S (APRN, BC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:S
Last Name:JARBOE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3464 ESSEX AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5752
Mailing Address - Country:US
Mailing Address - Phone:770-541-2114
Mailing Address - Fax:
Practice Address - Street 1:1707 NORTH BLAIRS BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168
Practice Address - Country:US
Practice Address - Phone:770-949-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN088693163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult