VICTORIA JACOBY


Address: 1521 N. 10th Street, Suite A, Blytheville, AR 72315
Phone: 8708387530

VICTORIA JACOBY (NPI# 1124417142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124417142
Entity Type Individual
Full Name VICTORIA JACOBY
Credential FNP-C
Practice Address 1521 N. 10th Street
Suite A
Blytheville
AR 72315
Mailing Address 1521 N 10th St
Suite A
Blytheville
AR 72315-1405
Practice Telephone 8708387530
Practice Fax Number 8708387539
Mailing Telephone 8708387530
Mailing Fax Number 8708387539
Enumeration Date 2015-01-14
Last Update Date 2017-01-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
A004275 AR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1521 N. 10TH STREET
SUITE A
City BLYTHEVILLE
State AR
Zip Code 72315

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1154736635 Hanna Kirk Case Manager/Care Coordinator 829 East Main St, Blytheville, AR 72315 2014-06-24
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811547003 Rose Mary Nichols Nurse Practitioner 1400 N Division St, Blytheville, AR 72315-1438 2019-09-19
1144563073 Katherine A Gurley Nurse Practitioner 1001 N 6th St, Blytheville, AR 72315-1707 2013-03-28
1861744773 Laura Marie Weatherford Nurse Practitioner 1100 Medical Dr Ste C, Blytheville, AR 72315-2437 2012-10-03
1245870989 Rachael Chandler Nurse Practitioner 1100 Medical Dr, Blytheville, AR 72315-1425 2020-01-10
1568000503 Chasity Shavon Campbell Nurse Practitioner 1521 N 10th St Ste A, Blytheville, AR 72315-1424 2019-12-19
1396117453 Peggy Darty Nurse Practitioner 1100 Medical Dr, Blytheville, AR 72315-1425 2015-10-28
1720402464 Connie Kay Ash Nurse Practitioner 1521 N 10th St, Suite C, Blytheville, AR 72315-1405 2014-02-18
1558594424 Valerie Denene Woodruff Nurse Practitioner 1521 N 10th St Ste F, Blytheville, AR 72315-1424 2009-08-26
1114096963 Christopher L Surratt Nurse Practitioner 1100 Medical Dr, Suite D, Blytheville, AR 72315-1425 2006-11-07

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1063010874 Phillip Wayne Stokes Jr. Nurse Practitioner 31 Ashcraft Ct, Paragould, AR 72450-7592 2020-10-14
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Competitor

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City BLYTHEVILLE
Zip Code 72315

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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