Individual
MICHAEL L JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
(608) 791-7162
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(608) 785-0940
(608) 791-7162
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
052138
WI
Other
Enumeration date
11/03/2005
Last updated
05/16/2019
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