Individual
TAWNIA LYNN JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CRNA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(203) 623-2512
Mailing address
5 BUNGALOW TER, SANDY HOOK, CT 06482-1234
(032) 623-2512
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
5597
CT
367500000X
Certified Registered Nurse Anesthetist
RNA223064
ME
Other
Enumeration date
11/06/2013
Last updated
02/13/2023
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