Individual
MR. DAVID ROBERT JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
58 JUNIPER CIR, FLORISSANT, CO 80816-9008
(719) 748-1036
(719) 748-1036
Mailing address
58 JUNIPER CIR, FLORISSANT, CO 80816-9008
(719) 748-1036
(719) 748-1036
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
Primary
NA-730527
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA-730527
CNA LICENSE
CO
Enumeration date
05/15/2014
Last updated
05/15/2014
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