MRS. BRENDA JOYCE JACOBS APN NPI 1720111990

NPI Information

NPI: 1720111990
Provider Name: MRS. BRENDA JOYCE JACOBS, APN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: MAINLINE HEALTH SYSTEMS INC

PECOS Registration: Yes

Address:
535 JORDAN DR
MONTICELLO, AR
ZIP 71655
Phone: (870) 367-6246
Get Directions

MRS. Brenda Joyce Jacobs, APN is a family nurse practitioner in Monticello, AR with 16 years of experience. MRS. Brenda Joyce Jacobs, APN NPI is 1720111990. 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:

535 JORDAN DR
MONTICELLO, AR
ZIP 71655-714
Phone: (870) 367-6246
Fax: (855) 926-7383

The NPI 1720111990 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 3/14/2007 and was last updated on 8/4/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	A03186	ARKANSAS	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	182729758	MEDICAID	ARKANSAS

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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