Individual
MRS. REAGAN ALANEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(800) 261-7193
Mailing address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(800) 261-7193
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-069611
AL
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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