Individual
MRS. BRENDA L JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
356 E MIDWAY RD, FORT PIERCE, FL 34982-7148
(772) 464-9746
(772) 464-9750
Mailing address
356 E MIDWAY RD, FORT PIERCE, FL 34982-7148
(772) 464-9746
(772) 464-9750
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP3289002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305240100
—
FL
Enumeration date
03/14/2006
Last updated
07/27/2009
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