Individual
KATHRYN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 653-9312
Mailing address
784 HERCULES DR, STE 110, COLCHESTER, VT 05446-8049
(802) 448-9755
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
0330772304
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017265
—
VT
05
—
30347940
—
NH
Enumeration date
05/27/2006
Last updated
10/11/2018
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