| Doctor Name: | AMANDA JAKUBOWSKI |
| NPI Number: | 1194118877 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4704254424 |
| Business Practice Address: | 245 E Warwick Dr Suite D Alma, MI - 488011026 |
| Business Phone Number: | 9894620048 |
| Business Fax Number: | |
| Mailing Address: | 1622 Holbrook Dr, HOLT |
| State: | MI |
| Postal Code: | 488421834 |
| Phone Number: | 9894888295 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2015 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 4704254424 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |