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General NPI Number Information
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NPI Number | 1134622806
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Entity Type | Individual
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Provider Name | JENNIFER JACOBS APRN
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Gender | Female
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 8970 MARKET ST
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City | DOVER
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State | AR
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Zip | 72837-9110
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Country | US
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Telephone | 479-331-3880
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Fax | 479-331-3788
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Provider Business Mailing Address
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Address Line | 892 RIDGEVIEW LN
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City | RUSSELLVILLE
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State | AR
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Zip | 72802-1737
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Country | US
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Telephone | 479-970-8086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A005482
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License Number State | AR
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