Provider Demographics
NPI:1013701317
Name:OLAERTS, JACOB SKY (PHARM STUDENT)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:SKY
Last Name:OLAERTS
Suffix:
Gender:M
Credentials:PHARM STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 S PARIS CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3281
Mailing Address - Country:US
Mailing Address - Phone:714-717-4432
Mailing Address - Fax:
Practice Address - Street 1:932 S PARIS CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3281
Practice Address - Country:US
Practice Address - Phone:714-717-4432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COIN.0002009384390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program