Provider Demographics
NPI:1437916848
Name:JACOBS, AMANDA COLLINS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:COLLINS
Last Name:JACOBS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6813 US HIGHWAY 74 W
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-9031
Mailing Address - Country:US
Mailing Address - Phone:910-301-1450
Mailing Address - Fax:
Practice Address - Street 1:705B LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5544
Practice Address - Country:US
Practice Address - Phone:910-610-4278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily