Individual
MARY BETH JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
680 RUSSELLVILLE RD, MOUNT HOLLY, VT 05758-9583
(802) 345-6559
Mailing address
1642 VT ROUTE 103 N, MOUNT HOLLY, VT 05758-9556
(802) 345-6559
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
026.0155457
VT
164W00000X
Licensed Practical Nurse
Primary
025.0135719
VT
Other
Enumeration date
12/10/2024
Last updated
01/16/2026
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