Individual
LOREN K JACOBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14535A HAZEL DELL PKWY, CARMEL, IN 46033-9401
(317) 705-4360
(317) 705-4361
Mailing address
15026 DECLARATION DR, WESTFIELD, IN 46074-8081
(317) 408-9989
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28133889A
IN
363L00000X
Nurse Practitioner
Primary
71008114A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300016056
—
IN
Enumeration date
01/19/2018
Last updated
02/21/2019
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