Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 430870 | NY |
NPI | 1043615123 |
---|---|
Provider Name | Julie-Ann Jacobs |
First Address | Morris Plains, NJ 07950-1904 |
Second Address | New York, NY 10016-6401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2014 |
Last Update Date | 04/02/2021 |