IndividualActive
Bennie Jacobs
NPI 1730920356 · Home Health Aide · Woodbury, MN
Provider details
- NPI number
- 1730920356
- Entity type
- Individual
- Primary specialty
- Home Health AideNursing Service Related Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 1104163 (MN)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
1671 Century Cir Apt 124
Woodbury, MN 55125-2116
Phone: (612) 220-8036
Approximate (ZIP-level) locationGet directions
Mailing address
1671 Century Cir Apt 124
Woodbury, MN 55125-2116
Registry dates
- Enumerated
- 2024-06-06
- Last updated
- 2024-06-06
- Certified
- 2024-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.