JACOB MAYBERRY AS-C NPI 1437311081

NPI Information

  • NPI: 1437311081
  • Provider Name: JACOB MAYBERRY, AS-C
  • Classification: Clinical Nurse Specialist - 364S00000X
  • Entity Type: Individual
  • Address: 104 BLUE WATER DR
    BRIDGEPORT, TX
    ZIP 76426
  • Phone: (940) 683-8078

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NPI Details

Jacob Mayberry, AS-C is a clinical nurse specialist in Bridgeport, TX. The provider is a registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. Jacob Mayberry, AS-C NPI is 1437311081. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

104 BLUE WATER DR
BRIDGEPORT, TX
ZIP 76426-336
Phone: (940) 683-8078
Fax: (940) 683-8078

The enumeration date for this NPI number is 6/25/2008 and was last updated on 6/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364S00000XClinical Nurse SpecialistTC08-0326ATEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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