Jacobs, Vickie L

Jacobs, Vickie L is an individual health care provider with primary practice located at W129N7055 Northfield Dr , Menomonee Falls WI 53051-0538. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jacobs, Vickie L can be contacted via phone (262) 253-5400.

Contact Information

Primary practice address
W129N7055 Northfield Dr Menomonee Falls WI 53051-0538
Fax: (262) 253-3399
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 799-023 Wisconsin

Profile Details

NPI number 1437266954
LBN Legal business name Jacobs, Vickie L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437266954 NPPES
Wisconsin MEDICAID 42950400

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