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

Mrs. Mini John Jacob, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1073032322

Mrs. Mini John Jacob, NURSEPRACTITIONER is a Nurse Practitioner in New Hyde Park, New York. Qualified in 2017, 9 years ago. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
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Practice location Address checks out

705 N 5th St
New Hyde Park, NY 11040-2931
Phone: (516) 358-5038
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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 F341923 (NY)

Record details

NPI number1073032322
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedSeptember 18, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

Other providers in New Hyde Park