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Individual

BRUCE E JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, BC

Contact information

Practice address
420 W MORRIS BLVD, STE. 400B, MORRISTOWN, TN 37813-2283
(423) 586-2410
(423) 581-9692
Mailing address
420 W MORRIS BLVD, STE. 400B, MORRISTOWN, TN 37813-2283
(423) 586-2410
(423) 581-9692

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12994
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12994
LICENSE
TN
05
3341623
TN
Enumeration date
12/03/2007
Last updated
06/24/2008
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