Individual
CARMEN JEAN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 110N, SAINT PAUL, MN 55114-1052
(651) 602-5311
(651) 222-6786
Mailing address
2550 UNIVERSITY AVE W, SUITE 110N, SAINT PAUL, MN 55114-1052
(651) 602-5311
(651) 222-6786
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9775
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127392200
—
MN
Enumeration date
09/20/2006
Last updated
08/22/2013
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