Individual
AUTUM RENEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
820 AINSWORTH DR STE A, PRESCOTT, AZ 86301-1613
(928) 771-5548
(928) 771-5549
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
314886
AZ
363LF0000X
Family Nurse Practitioner
Primary
314886
AZ
Other
Enumeration date
11/19/2024
Last updated
09/29/2025
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