Individual
JENNIFER RENEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3605
(616) 455-7300
Mailing address
7947 ENGELHURST DR, JENISON, MI 49428-8552
(615) 962-5587
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704223098
MI
Other
Enumeration date
10/11/2020
Last updated
10/11/2020
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