Provider Demographics
NPI:1114763323
Name:JACOBOVITS, RACHEL KAYLA (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KAYLA
Last Name:JACOBOVITS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 S COOKS BRIDGE RD STE 2-14
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2463
Mailing Address - Country:US
Mailing Address - Phone:732-876-3376
Mailing Address - Fax:732-876-0276
Practice Address - Street 1:27 S COOKS BRIDGE RD STE 2-14
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2463
Practice Address - Country:US
Practice Address - Phone:732-876-3376
Practice Address - Fax:732-876-0276
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15037600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily