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General NPI Number Information
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NPI Number | 1639414220
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Entity Type | Individual
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Provider Name | WENDY JUNE JACOBI CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 800 HADDONFIELD RD
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2604
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Country | US
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Telephone | 856-663-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 28 VERSAILLES BLVD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-5133
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Country | US
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Telephone | 570-977-6636
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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 | SP012560
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License Number State | PA
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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 | 26NJ00641900
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License Number State | NJ
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