Individual
ANGELA T JACOBS
Active
Individual
ANGELA T JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
10858517-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
10858517-4405
UT
Other
Enumeration date
07/31/2023
Last updated
10/09/2024
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