Individual
AMANDA JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 E CENTRAL AVE, DECATUR, IL 62521-4665
(217) 877-9117
Mailing address
1307 JACKSON WOODS CT NW, CEDAR RAPIDS, IA 52405-1920
(319) 521-3537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008421
IL
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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