Healthcare Provider Details

I. General information

NPI: 1306061338
Provider Name (Legal Business Name): DONNA FRANCIS JACOBS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HEALTH CENTER CAMPUS DR UNIVERSITY OF MARYLAND
COLLEGE PARK MD
20742-0001
US

IV. Provider business mailing address

7407 SUMMIT AVE
CHEVY CHASE MD
20815-4049
US

V. Phone/Fax

Practice location:
  • Phone: 301-314-8147
  • Fax:
Mailing address:
  • Phone: 301-654-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRO35827
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: