Individual
MRS. KELLY D JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1921 KALISTE SALOOM RD STE 117, LAFAYETTE, LA 70508-6183
(337) 210-5827
Mailing address
1921 KALISTE SALOOM RD STE 117, LAFAYETTE, LA 70508-6183
(337) 210-5827
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
234723
LA
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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