Jacobs, Willetta Rozena

Jacobs, Willetta Rozena is an sole proprietor health care provider with primary practice located at 1847 S Lake Dr , Lexington SC 29073-7759. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jacobs, Willetta Rozena can be contacted via phone (803) 356-8998.

Contact Information

Primary practice address
1847 S Lake Dr Lexington SC 29073-7759
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 21873 South Carolina

Profile Details

NPI number 1033326590
LBN Legal business name Jacobs, Willetta Rozena
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2007
Last updated Sep 13th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033326590 NPPES
South Carolina MEDICAID NP5401

Popular Providers