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Individual

SANDRA JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN CPNP

Contact information

Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
(614) 722-4565
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
(614) 722-4565

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
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