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NPI Code Detail

MEDICARE: STEPHANIE B JACOBS MSN, CRNP

MEDICARE: STEPHANIE B JACOBS MSN, CRNP
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
1363LF0000XFamily Nurse PractitionerVP004219BPA

General Provider Information

NPI Number : 1639298441
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE B JACOBS MSN, CRNP
Provider Business Mailing Address
First Line : 2401 ANTRIM CT
Second Line :
City : PITTSBURGH
State : PA
Zip : 15237-6611
Country : US
Telephone Number : 412-367-1331
Fax Number :
Provider Business Practice Location Address
First Line : 429 4TH AVE FL 7
Second Line :
City : PITTSBURGH
State : PA
Zip : 15219-1500
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 08/07/2025

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