| Doctor Name: | CHRISTINE JACOB |
| NPI Number: | 1023334364 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN126358 |
| Business Practice Address: | 5710 Sugarloaf Pkwy Lawrenceville, GA - 300437834 |
| Business Phone Number: | 7702372222 |
| Business Fax Number: | 7702372282 |
| Mailing Address: | 1095 Wake Robin Cir Sw, LILBURN |
| State: | GA |
| Postal Code: | 300471881 |
| Phone Number: | 7708569339 |
| Fax Number: | 4045154023 |
| NPI Enumeration Date: | 04/12/2010 |
| NPI Last Update Date: | 03/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN126358 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |