Individual
MELISSA MARIE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
N 1975 COUNTY HIGHWAY N, COLUMBUS, WI 53925-9766
(608) 692-8466
Mailing address
N 1975 COUNTY HIGHWAY N, COLUMBUS, WI 53925-9766
(608) 692-8466
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
88620-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40003300
—
WI
Enumeration date
05/03/2007
Last updated
07/09/2007
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