Individual
MISS KATIE ANN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1300 E 86TH ST STE 35, INDIANAPOLIS, IN 46240-1990
(317) 810-0045
(317) 810-8171
Mailing address
8504 SCENIC VIEW DR APT 210, FISHERS, IN 46038-4239
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024648A
IN
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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