Provider Demographics
NPI:1104096965
Name:JACOB, APRIL CURTIS (PA-C)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:CURTIS
Last Name:JACOB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MULBERRY ST SW
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5720
Mailing Address - Country:US
Mailing Address - Phone:828-757-5965
Mailing Address - Fax:828-757-5104
Practice Address - Street 1:1731 CONNELLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-7827
Practice Address - Country:US
Practice Address - Phone:828-757-6300
Practice Address - Fax:828-757-6324
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01855363A00000X, 363A00000X
CAPA 19623363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC7907AMedicare PIN