Individual
MRS. SELIN K JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
4221 VENETIAN LOOP, LAS CRUCES, LAS CRUCES, NM 88011-4126
(575) 640-0052
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02040
NM
Other
Enumeration date
10/19/2012
Last updated
08/17/2023
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