Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carla Jacob

Individual provider School Registered Nurse · NPI 1497063010

Carla Jacob is a Nurse Practitioner in Baltimore, Maryland. Qualified in 2015, 11 years ago. Practices with Mnr Industries, LLC, a 143-clinician group and accepts Medicare assignment. Licensed in Maryland and New York.

Years since qualifying
11
Licensed in
MD, NY
In the registry since
2010
Specialties on file
3
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Practice location Address checks out

22 S Greene St
Baltimore, MD 21201-1544
Phone: (347) 268-4390
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R248512 (MD)
School Registered Nurse Taxonomy 163WS0200X · Licence 542089 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 340624 (NY)

Record details

NPI number1497063010
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 16, 2010
Last updated in NPPESAugust 24, 2023
Certification dateAugust 24, 2023
Mailing address22 S Greene St, Baltimore, MD 21201-1544

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Mnr Industries, Llc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

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