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NPI Code Detail

MEDICARE: MRS. BRENDA L JACOBS ARNP

MEDICARE: MRS. BRENDA L JACOBS ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerARNP3289002FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538138599
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA L JACOBS ARNP
Provider Business Mailing Address
First Line : 356 E MIDWAY RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7148
Country : US
Telephone Number : 772-464-9746
Fax Number : 772-464-9750
Provider Business Practice Location Address
First Line : 356 E MIDWAY RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7148
Country : US
Telephone Number : 772-464-9746
Fax Number : 772-464-9750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/27/2009

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