Individual
ROSA E JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
523 W MISSOURI AVE, PHOENIX, AZ 85013-1828
(623) 229-5721
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
233784
AZ
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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