Individual
KIMBERLY HEWLETT JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-3328
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041445163
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
1049116
TX
367500000X
Certified Registered Nurse Anesthetist
209020852
IL
Other
Enumeration date
12/09/2019
Last updated
08/07/2023
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