Jacobs, Jeannine M

Jacobs, Jeannine M is an individual health care provider with primary practice located at 29 N Academy St , Greenville SC 29601-2629. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Jacobs, Jeannine M can be contacted via phone (864) 331-1300.

Contact Information

Primary practice address
29 N Academy St Greenville SC 29601-2629
Phone: (864) 331-1300
Fax: (864) 331-1447
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 1686 South Carolina

Profile Details

NPI number 1144270752
LBN Legal business name Jacobs, Jeannine M
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Mar 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144270752 NPPES
South Carolina MEDICAID NP0833

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