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1194440222
LISHA JACOB
BALTIMORE, MD
NPI
1194440222
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: TX 916213)
Enumeration Date
2022-10-11
Last Update Date
2022-10-11
Business Address
LISHA JACOB
525 N WOLFE ST
BALTIMORE, MD 21205-2110
Phone number: 410-955-4766
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Mailing Address
LISHA JACOB
2049 LAKE BEND DR
IRVING, TX 75060-7743
Phone number: 214-780-6061
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