Provider Demographics
NPI:1134647316
Name:JACOBS, BERNADETTE (REGISTER NURSE)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 SPROUL RD.
Mailing Address - Street 2:#1
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008
Mailing Address - Country:US
Mailing Address - Phone:610-353-7360
Mailing Address - Fax:
Practice Address - Street 1:ACCUCARE HOME NURSING 1999 SPROUL RD
Practice Address - Street 2:# 1
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008
Practice Address - Country:US
Practice Address - Phone:610-353-7360
Practice Address - Fax:610-353-7013
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN665969163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse