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General NPI Number Information
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NPI Number | 1154890085
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Entity Type | Individual
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Provider Name | LORI A JACOBS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 6040 TELETOWNE DR
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City | TOLEDO
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State | OH
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Zip | 43612-4603
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Country | US
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Telephone | 855-200-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 5646 KYLIE CT
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City | SYLVANIA
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State | OH
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Zip | 43560-9910
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Country | US
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Telephone | 419-466-0001
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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 | 11011969
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0028832
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704184898NSA2103P
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 199127
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License Number State | OH
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