Individual
LORI JEAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 835-1100
(920) 835-1099
Mailing address
PO BOX 1866, GREEN BAY, WI 54305-1866
(920) 445-7222
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2857
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006000655
AMERICAN NURSES CREDENTIALING CENTER
—
Enumeration date
07/20/2006
Last updated
11/08/2021
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