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General NPI Number Information
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NPI Number | 1457714677
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Entity Type | Individual
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Provider Name | JACOBE HOLLIS MSN, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 800 GLENWOOD AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-1814
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Country | US
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Telephone | 470-447-5031
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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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 | RN176691
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License Number State | GA
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