Individual
KIPPEN MARSHALL JACOBSON
Active
Individual
KIPPEN MARSHALL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
960
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497802920
NPI NUMBER
AK
01
—
K161914
MEDICARE PTAN
AK
05
—
RH047FQ
—
AK
Enumeration date
01/05/2007
Last updated
11/11/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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