Individual
GLENDA R. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
4750 WATERS AVE, SUITE 452, SAVANNAH, GA 31404-6200
(912) 350-5909
(912) 350-5914
Mailing address
4750 WATERS AVE, SUITE 452, SAVANNAH, GA 31404-6200
(912) 350-5909
(912) 350-5914
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN029458
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569140
WELLCARE
GA
05
—
885842548A
—
GA
01
—
P00869908
RR MEDICARE
GA
Enumeration date
07/06/2010
Last updated
02/07/2011
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