Provider Demographics
NPI:1366818809
Name:JACOBS, SHARON
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305198
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803-5198
Mailing Address - Country:US
Mailing Address - Phone:340-776-8311
Mailing Address - Fax:
Practice Address - Street 1:9048 SUGAR EST
Practice Address - Street 2:SRMC
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3634
Practice Address - Country:US
Practice Address - Phone:340-776-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRRT100602279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care