Individual
KHIRA R JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35707 N 33RD LN, PHOENIX, AZ 85086-2289
(623) 445-7810
Mailing address
35707 N 33RD LN, PHOENIX, AZ 85086-2289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
227538
AZ
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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