Provider Demographics
NPI:1881980522
Name:TOLBERT, JASMINE NASHEL
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:NASHEL
Last Name:TOLBERT
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:PO BOX 3163
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-3163
Mailing Address - Country:US
Mailing Address - Phone:910-874-5523
Mailing Address - Fax:910-323-0278
Practice Address - Street 1:111 LAMON ST STE 207
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4957
Practice Address - Country:US
Practice Address - Phone:910-323-8500
Practice Address - Fax:910-323-0278
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4154374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide