Individual
KRISTEN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
11207 MALLORY CT, ROANOKE, IN 46783-8602
(260) 615-6883
Mailing address
11207 MALLORY CT, ROANOKE, IN 46783-8602
(260) 255-4360
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
28184331A
IN
Other
Enumeration date
07/12/2023
Last updated
08/01/2023
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