MRS. EDWINA YVONNE JACOBS (NPI# 1063765451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063765451 |
| Entity Type | Individual |
| Full Name | MRS. EDWINA YVONNE JACOBS |
| Credential | FNP |
| Practice Address |
610 Strickland Dr Ste 340 Orange TX 77630-4788 |
| Mailing Address |
9157 Hillebrandt Rd Beaumont TX 77705-8294 |
| Practice Telephone | 4096700044 |
| Practice Fax Number | 4096700007 |
| Mailing Telephone | 4097962214 |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2016-08-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
654339 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | APRN | AP122669 | 01 |
| TX | DEA | MJ2767448 | 01 |
| TX | BOARD OF NURSING FAMILY PRACTICE NURSE PRACTITIONER LICENSE | 654339 | 01 |
| TX | PRESCRIPTIVE AUTHORIZATION | 13293 | 01 |
| Street Address |
610 STRICKLAND DR STE 340 |
| City | ORANGE |
| State | TX |
| Zip Code | 77630-4788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861650574 | Glenda Wilburn | Nurse Practitioner | 610 Strickland Dr Ste 340, Orange, TX 77630-4788 | 2008-05-29 |
| 1659922862 | Amy Michelle Henry | Family Medicine | 610 Strickland Dr Ste 340, Orange, TX 77630-4788 | 2019-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548685159 | Healthcare Warehouse, LLC | Durable Medical Equipment & Medical Supplies | 3515 Mockingbird St. Ste C, Orange, TX 77630 | 2014-02-19 |
| 1346688637 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 1302 Cypress St., Orange, TX 77630 | 2013-06-07 |
| 1740567510 | Mary Cannatella | Pharmacist | 1408 16th Street, Orange, TX 77630 | 2011-11-08 |
| 1811292642 | Inlightened Safe Haven | Contractor | 828 Nth 28th St., Orange, TX 77630 | 2011-01-26 |
| 1437472107 | Frank's Medical Mart, Inc | Durable Medical Equipment & Medical Supplies | 1619 Strickland Dr, Orange, TX 77630 | 2010-03-09 |
| 1952427403 | Assisted Living Concepts Inc | Assisted Living Facility | 5301 Meeks Drive, Orange, TX 77630 | 2007-03-22 |
| 1013033364 | Ronda Lynn Hathaway | Psychologist | 2495 N Mlk Dr, Orange, TX 77630 | 2007-03-21 |
| 1487790333 | The Eye Place, Inc. | Eyewear Supplier (Equipment, not the service) | 1502 Strickland Dr Ste 2, Orange, TX 77630 | 2007-01-29 |
| 1538220710 | Sheila R Cole | Nurse Practitioner | 2014 N.10th St., Orange, TX 77630 | 2006-12-12 |
| 1063583896 | Nina P Scales Leifeste | Dentist | 1509 Burton, Orange, TX 77630 | 2006-11-13 |
| Find all providers in zip 77630 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452966 | Velvet Maloy | Nurse Practitioner | 1312 County Road 3139, Orange, TX 77632-1633 | 2020-09-18 |
| 1265048151 | Christina Marie O'guinn | Nurse Practitioner | 2660 N Santiago Blvd # 100, Orange, CA 92867-1859 | 2020-09-16 |
| 1548871429 | Holley Moreau | Nurse Practitioner | 6136 Crosstimber Dr, Orange, TX 77632-7610 | 2020-08-13 |
| 1174147581 | Stephanie Michelle Chapman | Nurse Practitioner | 387 N Clark St, Orange, CA 92868-2218 | 2020-06-01 |
| 1952920621 | Natasha Caruth | Nurse Practitioner | 301 Seven Oaks Way, Orange, NJ 07050-3376 | 2020-04-13 |
| 1053944488 | Laura Lee Arvizo | Nurse Practitioner | 432 County Road 3139, Orange, TX 77632-1532 | 2020-02-13 |
| 1447801402 | Joel George Pohorence | Nurse Practitioner | 10080 E Greenwood Dr, Orange, TX 77630-3241 | 2019-09-21 |
| 1477114122 | Beverley P Brownell | Nurse Practitioner | 1215 E. Chapman Avenue, Orange, CA 92866 | 2019-06-24 |
| 1568924793 | Denise Giovanazzi Weinberg | Nurse Practitioner | 3215 East Abbey Lane, Orange, CA 92867 | 2019-04-05 |
| 1033688445 | Tatiana Tumeniuk | Nurse Practitioner | 240 Indian River Rd Ste A5, Orange, CT 06477-3690 | 2018-11-14 |
| Find all providers in ORANGE | ||||
Please comment or provide details below to improve the information on MRS. EDWINA YVONNE JACOBS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.