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NPI Code Detail

MEDICARE: BREHANNA JACOBS L.AC

MEDICARE: BREHANNA JACOBS L.AC
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
1171100000XAcupuncturistAP4636FL

General Provider Information

NPI Number : 1912860594
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREHANNA JACOBS L.AC
Provider Business Mailing Address
First Line : 104 W 5TH AVE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-6125
Country : US
Telephone Number : 850-841-9648
Fax Number :
Provider Business Practice Location Address
First Line : 104 W 5TH AVE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-6125
Country : US
Telephone Number : 850-841-9648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ BREHANNA JACOBS L.AC” Practice Location

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