| Contact Information | |
|---|---|
| First Name | Nikki |
| Last Name | Jacobs |
| Address | 3276 Ragweed Valley Rd. |
| City | Royal |
| State | AR |
| Province | |
| Zip/Postal Code | 71968 |
| Country | United States |
| Home Phone | 501 - 991-3017 |
| Work Phone | 870 - 490-0555 |
| Fax | |
| deshay2@peoplepc.com | |
| Alternate Email | jacobs.3@hotmail.com |
| Website Address | deshay2@peoplepc.com |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Taylor Jacobs - |
| Date of Injury | 3-3-04 |
| Type of Injury | Obstetric |