Individual
MAUREEN MCDONALD JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP01981
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049394202
—
TX
05
—
1900117
—
LA
Enumeration date
10/17/2006
Last updated
03/14/2023
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