Individual
MS. TRACIE M JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2437 WILLWOOD DR, FLORENCE, SC 29501-3904
(843) 777-3100
Mailing address
1349 FOX HOLLOW DR, HARTSVILLE, SC 29550-4659
(843) 858-4569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
259756
SC
363LF0000X
Family Nurse Practitioner
Primary
29222
SC
Other
Enumeration date
08/09/2023
Last updated
11/12/2024
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