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NPI Code Detail

MEDICARE: MRS. CHERYL ANN JACOBS CPNP

MEDICARE: MRS. CHERYL ANN JACOBS CPNP
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
1363LP0200XPediatric Nurse PractitionerRN 186729OH
2363LP0808XPsychiatric/Mental Health Nurse PractitionerNP10125OH
3363LP0200XPediatric Nurse PractitionerNP10125OH

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 : 1790939924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL ANN JACOBS CPNP
Provider Business Mailing Address
First Line : 970 W WOOSTER ST RM 130
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-2652
Country : US
Telephone Number : 419-352-6890
Fax Number :
Provider Business Practice Location Address
First Line : 970 W WOOSTER ST RM 130
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-2652
Country : US
Telephone Number : 419-352-6890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2008
Last Update Date : 03/14/2023

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