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Individual
LEAH JACOBS
Active
Individual
LEAH JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
RN209956
GA
363LF0000X
Family Nurse Practitioner
Primary
RN209956
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN209965
STATE LICENSE
—
Enumeration date
09/05/2017
Last updated
11/30/2019
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