Individual
JACQUELYN JANIS JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1300 MEDICAL DR, TALLAHASSEE, FL 32308-4646
(850) 879-2628
Mailing address
2500 STATE ROAD 44 UNIT 12201, NEW SMYRNA BEACH, FL 32168-8282
(850) 879-2628
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11029832
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11029832
FL
Other
Enumeration date
04/27/2024
Last updated
01/28/2025
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