Individual
NATHAN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-9010
(859) 301-9018
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-9010
(859) 301-9018
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3015130
KY
363LF0000X
Family Nurse Practitioner
3015130
KY
363LF0000X
Family Nurse Practitioner
APRN.CNP.0035789
OH
Other
Enumeration date
09/01/2021
Last updated
11/15/2024
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