# LAVONNE JACOBSEN

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

## Provider details

- **NPI number:** 1922265800
- **Gender:** F
- **Credential:** APRN, CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | NMW621 | CA | Yes |

## Other

- **Enumeration date:** 05/19/2008
- **Last updated:** 07/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NMW006210 | MEDI-CAL | CA |
| 01 | — | R 0101207 | OKLAHOMA ADVANCED PRACTICE REGISTERED NURSE LICENSE | OK |
| 01 | — | ZZZ37640Z | BLUE SHIELD | CA |