Individual
MRS. MARY ANN JACOBS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 894-5727
(314) 845-5039
Mailing address
514 FORDER RD, SAINT LOUIS, MO 63129-2624
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
047282
MO
Other
Enumeration date
04/13/2006
Last updated
07/08/2007
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