Individual provider · Type 1 NPI
Carol Ilma Jacobs, NP
Adult Health Nurse Practitioner · Cleveland, WI
NPI number
1255354064
Active
Practice location
1205 North Ave
Cleveland, WI 53015-1413
Fax (920) 693-5604
Mailing address
1274 Meadowbrook Drive
Cleveland, WI 53015
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 137 (WI) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1255354064
Carol Ilma Jacobs, NP's National Provider Identifier is 1255354064, issued on Jul 25, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Cleveland, WI. The record was last updated on Jul 8, 2007.