| NPI | 1073780441 |
|---|---|
| Former Name | MISTY D JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 53750) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35) |
| 207Q00000X Family Medicine (Licence: AL MD.38961) | |
| 207Q00000X Family Medicine (Licence: IN 01065155A) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2025-09-02 |