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MRS. MICHELLE VERONICA JACOB NP NPI 1033548045


NPI Information

NPI: 1033548045
Provider Name: MRS. MICHELLE VERONICA JACOB, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC

PECOS Registration: Yes

Address:
4500 MEMORIAL DR
DEPT ANESTHESIOLOGY
BELLEVILLE, IL
ZIP 62226
Phone: (800) 862-9980
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MRS. Michelle Veronica Jacob, NP is an adult health nurse practitioner in Belleville, IL with 11 years of experience. MRS. Michelle Veronica Jacob, NP NPI is 1033548045. 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:

4500 MEMORIAL DR
DEPT ANESTHESIOLOGY
BELLEVILLE, IL
ZIP 62226-360
Phone: (800) 862-9980
Fax: (314) 362-7785

The NPI 1033548045 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/11/2013 and was last updated on 11/15/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2200XNurse PractitionerAdult Health209011680ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1420022730MEDICAIDMISSOURI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.