Amanda Jacobs

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

324705 Issued in NY

Practice address

1161 Cain Rd
Youngstown, NY 14174-9768

Phone

(716) 425-0211

NPI assigned

May 3, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1003261561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 CAIN RD",
            "city": "YOUNGSTOWN",
            "state": "NY",
            "postal_code": "141749768",
            "telephone_number": "716-425-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 CAIN RD",
            "city": "YOUNGSTOWN",
            "state": "NY",
            "postal_code": "141749768",
            "telephone_number": "716-425-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "324705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Rose Downie, RNFA RN FIRST ASSIST
• Functional Nutrition of Western New York, PLLC
• Serena Grainge, EMT-B
• Mark Kenneth Herbst, MS,CCC/SLP
• Laurie Ann Hewitt, RPH
• Colleen Mary Johnson, LMSW, CSW
• Danielle Julias, P.T.
• Susan Elizabeth Keegan, DPT
• Nitasha Khurana, B. SC.
• Danielle C Kudela, LCSW

• Licensed Practical Nurse in Youngstown, NY
• Providers in Youngstown, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.