Individual
MS. VICKI TINDEL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
450 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Mailing address
4961 FORESTGLADE CT, STONE MOUNTAIN, GA 30087-1314
(404) 294-0499
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN085351
GA
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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