Individual
ASHLEY MARIE JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4100 LAKE DR SE STE D, GRAND RAPIDS, MI 49546-8292
(616) 391-7580
Mailing address
4100 LAKE DR SE STE D, GRAND RAPIDS, MI 49546-8292
(616) 391-7580
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG09180029
MI
Other
Enumeration date
12/30/2018
Last updated
12/30/2018
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