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General NPI Number Information
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NPI Number | 1316814163
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Entity Type | Individual
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Provider Name | ELIZABETH RENEE JACOBS HIS
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Gender | Female
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 6565 ARLINGTON BLVD STE 503
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3018
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Country | US
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Telephone | 571-565-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 6506 LOISDALE RD STE 106
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1815
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Country | US
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Telephone | 703-888-3425
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 2101002931
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License Number State | VA
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