Individual
MONA PEARL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
0990301
CO
2084N0400X
Neurology Physician
0990301
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
APN.0990301-NP
CO
363LP0200X
Pediatric Nurse Practitioner
SNP 100038
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86608304
—
CO
Enumeration date
12/08/2006
Last updated
09/10/2024
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