MRS. MARILEEN ANN JACOBS NPI 1023019494

NPI Information

NPI: 1023019494
Provider Name: MRS. MARILEEN ANN JACOBS
Classification: Orthotic Fitter - 225000000X
Entity Type: Individual
Address:
1512 E GILBERT AVE
COEUR D ALENE, ID
ZIP 83815
Phone: (208) 664-4398
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MRS. Marileen Ann Jacobs is an orthotic fitter in Coeur D Alene, ID. The provider is an individual trained in the management of fitting prefabricated orthoses. MRS. Marileen Ann Jacobs NPI is 1023019494. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1512 E GILBERT AVE
COEUR D ALENE, ID
ZIP 83815-216
Phone: (208) 664-4398
Fax: (208) 667-4733

The enumeration date for this NPI number is 8/9/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225000000X	Orthotic Fitter				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000010014587	OTHER	IDAHO	REGENCE BLUE SHIELD
2	8A760	OTHER	IDAHO	BLUE CROSS
3	0375570001	MEDICARE ID-TYPE UNSPECIFIED	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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