Individual
MR. JAMES RANDALL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
Mailing address
13023 CROWN POINT AVE, OMAHA, NE 68164-1367
(402) 212-0245
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
22050
NE
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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