Individual provider · Type 1 NPI

Michelle Veronica Jacob, AGNP

Adult Health Nurse Practitioner · Belleville, IL

NPI number 1033548045 Active

Practice location

4500 Memorial Dr, Dept Anesthesiology
Belleville, IL 62226-5360

Fax (314) 362-7785

Mailing address

PO Box 7412011
Chicago, IL 60674-2011

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X209011680 (IL)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1033548045

Michelle Veronica Jacob, AGNP's National Provider Identifier is 1033548045, issued on Nov 11, 2013. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Belleville, IL. The record was last updated on Apr 21, 2025.