Individual
JESSICA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4194
(702) 388-4000
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
009373
AZ
207R00000X
Internal Medicine Physician
Primary
DO3443
NV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
DO3443
NV
207RP1001X
Pulmonary Disease Physician
DO3443
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
04/03/2026
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