Provider Demographics
NPI:1447143268
Name:JACOBO, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:JACOBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4133
Mailing Address - Country:US
Mailing Address - Phone:402-860-3652
Mailing Address - Fax:
Practice Address - Street 1:109 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4133
Practice Address - Country:US
Practice Address - Phone:402-860-3652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker