Individual provider · Type 1 NPI
Mavis Jacobs, R.N.
General Practice Registered Nurse · Elmhurst, NY
NPI number
1073889416
Active
Practice location
8055 Cornish Ave
Elmhurst, NY 11373-3728
Mailing address
18811 Suffolk Dr
St. Albans, NY 11412-3008
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Registered Nurse Primary | 163WG0000X | 528003-1 (NY) |
General Practice Registered Nurse: Definition to come...
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About NPI 1073889416
Mavis Jacobs, R.N.'s National Provider Identifier is 1073889416, issued on Mar 29, 2012. The primary taxonomy on file is General Practice Registered Nurse (163WG0000X), and the practice location is in Elmhurst, NY. The record was last updated on Mar 29, 2012.