Individual
JULIE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7400 MANNING AVE N, STILLWATER, MN 55082-8419
(651) 283-5116
Mailing address
7400 MANNING AVE N, STILLWATER, MN 55082-8419
(651) 283-5116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
129243-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129243-5
MINNESOTA BOARD OF NURSING
MN
Enumeration date
06/18/2020
Last updated
06/18/2020
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