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

Mavis Jacobs, RN

Individual provider General Practice Registered Nurse · NPI 1073889416

Mavis Jacobs, RN is a General Practice Registered Nurse in Elmhurst, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

8055 Cornish Ave
Elmhurst, NY 11373-3728
Phone: (718) 899-6258
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Registered Nurse (primary) Taxonomy 163WG0000X · Licence 528003-1 (NY)

Record details

NPI number1073889416
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedMarch 29, 2012
Last updated in NPPESMarch 29, 2012
Mailing address18811 Suffolk Dr, Saint Albans, NY 11412-3008

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