# RICKY JACOBSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619335676
- **Gender:** F
- **Credential:** RN, MSN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | 70383105 | PA | — |
| 163WG0000X | General Practice Registered Nurse | RN162041L | PA | Yes |

## Other

- **Enumeration date:** 02/05/2016
- **Last updated:** 02/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 70383105 | AMERICAN ASSOCIATION OF DRUGLESS PRACTIONERS | PA |