Individual
MRS. LANA RAE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY NURSE PRACTIT
Contact information
Practice address
1401 NW 9TH STREET, GRAND RAPIDS, MN 55744
(218) 327-4961
Mailing address
1542 GOLF COURSE RD STE 203, GRAND RAPIDS, MN 55744-3557
(218) 322-4900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
120342-4
MN
363LF0000X
Family Nurse Practitioner
Primary
0257857-22
MN
Other
Enumeration date
09/17/2012
Last updated
10/26/2020
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