Individual
KATHY LANAE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3875 STADIUM WAY, OGDEN, UT 84408-5157
(801) 564-5158
Mailing address
619 E 2475 N, NORTH OGDEN, UT 84414-2824
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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