Provider Demographics
NPI:1689458382
Name:JACOBS, LINDSEY ALEXIS (DNP, CPNP-PC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ALEXIS
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ALEXIS
Other - Last Name:VANLIEROP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49057-1129
Mailing Address - Country:US
Mailing Address - Phone:269-621-5313
Mailing Address - Fax:
Practice Address - Street 1:1540 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4000
Practice Address - Country:US
Practice Address - Phone:734-232-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704343048363LP0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse