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Individual

JACQUELINE MARIE JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
608 E UNION ST, MEDINA, OH 44256-1962
(330) 591-0787
Mailing address
608 E UNION ST, MEDINA, OH 44256-1962
(330) 591-0787

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN.382563
OH

Other

Enumeration date
12/04/2020
Last updated
12/04/2020
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