Provider Demographics
NPI:1831966100
Name:LIBOON, JAZMINE SIMONE
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:SIMONE
Last Name:LIBOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EAST CAROLINA UNIVERSITY COLLEGE OF NURSING
Mailing Address - Street 2:600 MOYE BLVD.
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 NC HIGHWAY 66 S STE 245
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3855
Practice Address - Country:US
Practice Address - Phone:336-992-5120
Practice Address - Fax:336-995-5122
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC932367A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program