Individual
RICKY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
280 PENNBROOK PKWY, LANSDALE, PA 19446-3843
(215) 643-1811
(215) 643-3712
Mailing address
112 GREEN VALLEY CIR, DRESHER, PA 19025-1515
(215) 459-3547
(215) 643-3712
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
70383105
PA
163WG0000X
General Practice Registered Nurse
Primary
RN162041L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70383105
AMERICAN ASSOCIATION OF DRUGLESS PRACTIONERS
PA
Enumeration date
02/05/2016
Last updated
02/05/2016
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