Individual
DR. KRISTIN A JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2230 PINE AVE, NIAGARA FALLS, NY 14301-2330
(716) 282-2225
(716) 284-0162
Mailing address
2230 PINE AVE, NIAGARA FALLS, NY 14301
(716) 282-2225
(716) 284-0162
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC010645
PA
111N00000X
Chiropractor
X009480
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16157459602
PRISM - UNIVERA ONLY
—
01
—
350051643
RR MEDICARE
—
01
—
829106
EMPIRE INS CO MPN
NY
01
—
8890408
INDEPENDENT HEALTH ASSO
NY
Enumeration date
09/15/2005
Last updated
07/21/2022
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