Individual
RANDI JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
170 N EAGLE CREEK DR STE 104, LEXINGTON, KY 40509-9087
(859) 967-5848
(859) 967-5473
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(859) 967-5748
(859) 967-5473
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3018860
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100874920
—
KY
Enumeration date
01/16/2023
Last updated
01/27/2025
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