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Individual

STACEY L JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1319 DUNCAN AVE, JEFFERSONVILLE, IN 47130-3759
(812) 283-2308
(812) 283-2832
Mailing address
1319 DUNCAN AVE, FAMILY HEALTH CENTER CLARK COUNTY, JEFFERSONVILLE, IN 47130-3759
(812) 283-2308
(812) 283-2832

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3010254
KY
363L00000X
Nurse Practitioner
Primary
71004631B
IN

Other

Enumeration date
09/25/2013
Last updated
10/11/2022
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