Individual
SHANA JACOBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7110 45TH ST, CHEVY CHASE, MD 20815-6035
(202) 247-0579
Mailing address
7110 45TH ST, CHEVY CHASE, MD 20815-6035
(202) 247-0579
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN500021661
DC
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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