Individual
HOLLY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7900 LEES SUMMIT RD, KANSAS CITY, MO 64139-1236
(816) 404-7500
(816) 404-7514
Mailing address
215 W 81ST TER, KANSAS CITY, MO 64114-2334
(913) 961-1695
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2014000951
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420016176
—
MO
Enumeration date
01/24/2014
Last updated
07/22/2021
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