Individual
MADEIA H. JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 N PRESIDENTIAL BLVD STE 103, BALA CYNWYD, PA 19004-1258
(215) 907-7911
Mailing address
3313 N MARSTON ST, PHILADELPHIA, PA 19129-1318
(610) 690-2500
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN293559L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194150896
—
PA
Enumeration date
09/12/2013
Last updated
04/29/2020
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