William Charles Jacobs, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30002294 Issued in WA

Practice address

816 8TH St NW
Puyallup, WA 98371-4129

Phone

(253) 770-9839

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1417037375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 8TH ST NW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714129",
            "telephone_number": "253-770-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 8TH ST NW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714129",
            "telephone_number": "253-770-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30002294",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00086779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyra Jackson
• Mackenzie Nicole Jackson, PT, DPT
• Brooke Jacobs
• Catrina M Jacobs
• Jane E Jacobs, M.S
• Charles D Jacobson, MD
• Kameryn A Jadoo
• Scott A Jahner, ARNP
• Matt Karl Jahns, LMP
• Melody Ann Jameson

• Family Nurse Practitioner in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.