Most Relevant Information
Provider Data
| NPI Number: | 1003261561 |
| Provider Name: | AMANDA JACOBS |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 324705 |
Most Important Dates
| Enumeration Date: | 05/03/2016 |
| Last Updated: | 05/03/2016 |
Provider Practice Location
1161 CAIN RD
YOUNGSTOWN
NY
141749768
Practice Location Phone/Fax
| Phone: | 7164250211 |
| Fax: |
Provider Mailing Location
1161 CAIN RD
YOUNGSTOWN
NY
141749768
Provider Mailing Phone/Fax
| Phone: | 7164250211 |
| Fax: |