Individual
DR. LOREN HENNING JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 MEMORIAL DR, BROKEN BOW, NE 68822-1378
(308) 872-2486
(308) 872-2027
Mailing address
PO BOX 690, BROKEN BOW, NE 68822-0690
(308) 872-6283
(308) 872-2027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11678
NE
Other
Enumeration date
12/13/2006
Last updated
07/13/2007
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