Individual
ANNIE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
3033 N CENTRAL AVE, PHOENIX, AZ 85012-2809
(602) 230-7373
(602) 682-7455
Mailing address
3620 N 3RD ST # 550, PHOENIX, AZ 85012-2020
(602) 230-7373
(602) 682-7455
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
250873
AZ
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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