Provider Demographics
NPI:1760523146
Name:JACOBS, NANCY ELIZABETH (ANP-C)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:JACOBS
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 JOLIE WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9347
Mailing Address - Country:US
Mailing Address - Phone:530-229-8058
Mailing Address - Fax:530-245-6752
Practice Address - Street 1:2640 BRESLAUER WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-4246
Practice Address - Country:US
Practice Address - Phone:530-229-8058
Practice Address - Fax:530-245-6752
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN405118363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health