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Individual

KAISA T JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8088 W WHITNEY DR, PEORIA, AZ 85345-6564
(920) 264-4130
Mailing address
2929 W THOMAS RD, PHOENIX, AZ 85017-5511
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
297002
AZ

Other

Enumeration date
09/20/2023
Last updated
09/23/2025
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