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Individual

KORTNEY JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
203 WESTGATE ROAD, SCOTT, LA 70506
(337) 326-4569
Mailing address
203 WESTGATE ROAD, SCOTT, LA 70506
(435) 749-1488

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP212553
LA
363LF0000X
Family Nurse Practitioner
6211903-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2539957
LA
Enumeration date
04/26/2016
Last updated
01/21/2025
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