Provider Demographics
NPI:1477639268
Name:JACOBS, ANNE C (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:C
Last Name:JACOBS
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GLIDDEN ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-3400
Mailing Address - Country:US
Mailing Address - Phone:207-523-9247
Mailing Address - Fax:207-563-1471
Practice Address - Street 1:10 GLIDDEN ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:ME
Practice Address - Zip Code:04553-3400
Practice Address - Country:US
Practice Address - Phone:207-523-9247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR41542171100000X
OR1459175F00000X
MEME415201171100000X
MEME415202175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist