Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lacey Kristine Jacobs, PA-C

Individual provider Physician Assistant · NPI 1891066445

Lacey Kristine Jacobs, PA-C is a Physician Assistant in Oklahoma City, Oklahoma. Qualified in 2011, 15 years ago. Practices with Medical Resource Management LLC, a 59-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
15
Licensed in
OK
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11601 S Western Ave
Oklahoma City, OK 73170-5823
Phone: (405) 512-6950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence APPA2099 (OK)

Record details

NPI number1891066445
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 13, 2012
Last updated in NPPESJanuary 13, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Medical Resource Management Llc — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

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