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General NPI Number Information
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NPI Number | 1972014199
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Entity Type | Individual
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Provider Name | MARIA ANNETTE JACOBS ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/15/2017
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Last Update Date | 10/15/2017
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Provider Practice Location Address
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Address Line | 2245 BALSAN WAY
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City | WELLINGTON
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State | FL
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Zip | 33414-6435
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Country | US
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Telephone | 561-795-7749
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Fax | 561-795-7749
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Provider Business Mailing Address
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Address Line | 2245 BALSAN WAY
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City | WELLINGTON
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State | FL
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Zip | 33414-6435
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Country | US
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Telephone | 561-385-7843
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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 | ARNP9207533
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License Number State | FL
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