Individual
JAMIE LEA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1112 OAK ST, CARMI, IL 62821
(618) 382-5030
Mailing address
611 S MARSHALL AVE, MC LEANSBORO, IL 62859-1213
(618) 643-2361
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209020413
IL
Other
Enumeration date
07/29/2019
Last updated
11/15/2019
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