Individual
JENNIFER LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-1500
(386) 231-1598
Mailing address
PO BOX 945921, ATLANTA, GA 30394-5921
(386) 231-4529
(386) 672-9904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11005326
FL
363LF0000X
Family Nurse Practitioner
APRN11005326
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11005326
FL
Other
Enumeration date
11/22/2019
Last updated
01/24/2024
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