| NPI | 1760290852 |
|---|---|
| Former Name | JESSICA MICHELLE JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-155808) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-155808) |
| Enumeration Date | 2024-12-21 |
| Last Update Date | 2025-08-02 |