Individual
MRS. JUDY JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
132 N DAKOTA AVE, SIOUX FALLS, SD 57104
(605) 367-8793
(605) 367-7283
Mailing address
904 PINEVIEW CR, HARTFORD, SD 57033
(605) 528-6567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0114
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5350010
—
SD
Enumeration date
09/20/2006
Last updated
07/09/2007
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