Individual
CANDY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
2721 HERITAGE DR, MINOT, ND 58703-1651
(701) 509-4573
Mailing address
2721 HERITAGE DR, MINOT, ND 58703-1651
(701) 509-4573
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
200987
ND
363LP2300X
Primary Care Nurse Practitioner
Primary
200987
ND
Other
Enumeration date
09/25/2024
Last updated
03/06/2025
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