Individual
SANDRA JACOBS
Active
Individual
SANDRA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
RN190931 NP3893
OH
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.03893
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2246500
—
OH
05
—
7102084000
—
WV
05
—
78012903
—
KY
Enumeration date
09/27/2005
Last updated
12/12/2024
Update your record
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