Individual
JENNA L JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-6435
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-6435
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20692
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024500600
—
FL
Enumeration date
01/23/2018
Last updated
04/30/2021
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