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General NPI Number Information
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NPI Number | 1497697817
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Entity Type | Individual
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Provider Name | ANDREA JACOBS
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Gender | Female
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 4709 HARFORD RD STE 27
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City | BALTIMORE
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State | MD
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Zip | 21214-3205
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Country | US
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Telephone | 443-527-0875
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Fax |
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Provider Business Mailing Address
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Address Line | 4709 HARFORD RD STE 27
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City | BALTIMORE
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State | MD
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Zip | 21214-3205
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Country | US
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Telephone | 443-527-0875
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 0203627
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HCSA-01098
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HCSA-01098
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License Number State | MD
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