Individual
DIANA LYNN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.,C.P.N.P.
Contact information
Practice address
2152 S VINEYARD, SUITE 129, MESA, AZ 85210-6871
(480) 732-0044
(480) 732-9333
Mailing address
2152 S VINEYARD, SUITE 129, MESA, AZ 85210-6871
(480) 732-0044
(480) 732-9333
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R.N.042819 PNP124
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431528
—
AZ
Enumeration date
02/24/2006
Last updated
12/01/2008
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