Provider Demographics
NPI:1760957856
Name:JACOBS, ASHLIE MARGRET (FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:MARGRET
Last Name:JACOBS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 COTTAGE RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-1466
Mailing Address - Country:US
Mailing Address - Phone:903-694-4824
Mailing Address - Fax:903-694-4621
Practice Address - Street 1:630 HURST ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3414
Practice Address - Country:US
Practice Address - Phone:936-657-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily