Individual
MR. KOLTON LANE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
407 E 3RD ST, DULUTH, MN 55805-1950
(218) 786-8364
Mailing address
2016 BIRCH AVE, PROCTOR, MN 55810-2555
(651) 497-1988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8879
MN
Other
Enumeration date
02/26/2022
Last updated
06/12/2023
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