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NPI Code Detail

MEDICARE: ROSEMARIE JACOBS

MEDICARE: ROSEMARIE JACOBS
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1629630009
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARIE JACOBS
Provider Business Mailing Address
First Line : 11565 OLD VIRGINIA RD APT A-211
Second Line :
City : RENO
State : NV
Zip : 89521-8982
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1005 TERMINAL WAY STE 125
Second Line :
City : RENO
State : NV
Zip : 89502-2198
Country : US
Telephone Number : 877-786-4999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2019
Last Update Date : 07/05/2019

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Directions to “ ROSEMARIE JACOBS ” Practice Location

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