Praisy Jacob, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704281141 Issued in MI

Practice address

50861 Nesting Ridge Dr
Macomb, MI 48044-1385

Phone

(586) 764-9892

NPI assigned

Aug 20, 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

Other names 1

• Praisy Samuel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471651200000",
    "number": "1104371020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50861 NESTING RIDGE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441385",
            "telephone_number": "586-764-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50861 NESTING RIDGE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441385",
            "telephone_number": "586-764-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "PRAISY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2016-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704281141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRAISY",
            "last_name": "SAMUEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elana Ishaya
• Kimberly Jane-Ziegler Iulianelli, MA CCC-SLP
• J James Agrusa, P.C.
• Keely Jackson, CERTIFIED
• Curt Alan Jacob, D.C.
• Alexa Jager, MSN, CPNP-PC
• Melissa Jannotte, PHARM D
• Jonathan Jarvie
• Kayla Jelinek, D.O.
• John E. George, D.D.S., P.C.

• Family Nurse Practitioner in Macomb, MI
• Providers in Macomb, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.