| NPI | 1205859451 | 
|---|---|
| Former Name | TANYA JANE JACOB | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 4026333)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024177701)  | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN13911)  | |
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2024-12-02 |