Individual
MS. MICHELLE ELAINE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
53 GRANDFIELD ST, DEDHAM, MA 02026-6906
(617) 823-0899
Mailing address
53 GRANDFIELD ST, DEDHAM, MA 02026-6906
(617) 823-0899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
217503
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN217503
MA
390200000X
Student in an Organized Health Care Education/Training Program
217503
MA
Other
Enumeration date
04/08/2014
Last updated
04/03/2026
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