Active NPI
Patricia Jacobs-Mann, ARNP
- Family Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1023091428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP0704
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (928) 592-2544
- NPI assigned
- Nov 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP0704 | AZ | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
436 S Desperado Dr
Cottonwood, AZ 86326-7398
Phone (480) 703-4702
Other practice location 1
436 S Desperado Dr # 2
Cottonwood, AZ 86326-7398
Phone (480) 703-4702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1023091428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 S DESPERADO DR",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863267398",
"telephone_number": "480-703-4702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "928-592-2544"
}
],
"practiceLocations": [
{
"address_1": "436 S Desperado Dr # 2",
"address_purpose": "LOCATION",
"city": "Cottonwood",
"state": "AZ",
"postal_code": "863267398",
"country_code": "US",
"telephone_number": "480-703-4702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS-MANN",
"first_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-21",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP0704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.