| NPI | 1508110776 |
|---|---|
| Former Name | BETH ANN JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-013053) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012038004) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2026-05-19 |