Individual
KIMBERLY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 SOUTH MAIN STREET, SUITE103, GREENSBURG, PA 15601
(412) 561-7246
(412) 235-4011
Mailing address
PO BOX 747, GREENSBURG, PA 15601
(412) 561-7246
(412) 235-4011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
VP004352B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VP004352B
LICENSE
PA
Enumeration date
08/23/2006
Last updated
07/29/2015
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