Provider Demographics
NPI:1497092951
Name:JACOBS, NICOLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:2068 S 18TH ST
Mailing Address - Street 2:#1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2770
Mailing Address - Country:US
Mailing Address - Phone:402-430-0430
Mailing Address - Fax:
Practice Address - Street 1:2068 S 18TH ST
Practice Address - Street 2:#1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2770
Practice Address - Country:US
Practice Address - Phone:402-430-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist