person
Mrs. Michelle Veronica Jacob, NP
Adult Health Nurse Practitioner in Belleville, Illinois
NPI 1033548045

Michelle Veronica Jacob is an Adult Health Nurse Practitioner based in Saint Louis, IL and is specialized in Adult Health. Michelle Veronica Jacob practices in Belleville, IL and has the professional credentials of NP. The NPI Number for Michelle Veronica Jacob is 1033548045 and holds a License No. 209011680 (Illinois).

The current practice location address for Michelle Veronica Jacob is 4500 Memorial Dr, Belleville, IL and can be reached out via phone at 800-862-9980 and via fax at 314-362-7785. You can also correspond with Michelle Veronica Jacob through the mailing address at 660 S EUCLID AVE, SAINT LOUIS, MO - 63110-1010 (mailing address contact number: 800-862-9980).

Location: 4500 Memorial Dr, Belleville, IL, 63110-1010
person
Provider Profile Details
NPI Number
1033548045
Provider Name
Michelle Veronica Jacob
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
4500 Memorial Dr, Belleville, IL, 63110-1010
Phone Number
800-862-9980
Fax Number
314-362-7785
Provider Enumeration Date
11/11/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
420022730 05 MO
institution
Provider Business Practice Location Address Details
Address
4500 Memorial Dr
City
State
Zip
62226-5360
Phone Number
800-862-9980
Fax Number
314-362-7785
person
Provider Business Mailing Address Details
Address
660 S Euclid Ave
City
State
Zip
63110-1010
Phone Number
800-862-9980
Fax Number
314-362-1185
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
209011680 (Illinois)
Definition
Definition to come...
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