Provider Demographics
NPI:1538375977
Name:JACOBS, EVE W (MSN,CRNP,RNC)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:W
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MSN,CRNP,RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:#225
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1209
Mailing Address - Country:US
Mailing Address - Phone:215-750-7771
Mailing Address - Fax:215-750-6935
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:#225
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1209
Practice Address - Country:US
Practice Address - Phone:215-750-7771
Practice Address - Fax:215-750-6935
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP001265G363LX0001X
NJ26NJ00053600363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS60731Medicare UPIN
PA013680Medicare PIN