Individual
BARBARA ANN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
902 N ORANGE ST, MISSOULA, MT 59802-2928
(406) 329-5736
(406) 329-2991
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200950085NP
OR
363LF0000X
Family Nurse Practitioner
Primary
128682
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168395
—
OR
01
—
R103163
MEDICARE PART B
OR
Enumeration date
07/16/2009
Last updated
03/17/2018
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