Individual
MICHAEL JACOBS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
609 ATTAIN ST STE 101, FUQUAY VARINA, NC 27526-1984
(919) 567-0684
Mailing address
2587 RAVENHILL DR, FAYETTEVILLE, NC 28303-5451
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5012389
NC
Other
Enumeration date
11/07/2019
Last updated
04/15/2025
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