Individual
SUZANNE M JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
80 1ST ST, PRAIRIE DU SAC, WI 53578-1550
(608) 643-3311
Mailing address
80 1ST ST, PRAIRIE DU SAC, WI 53578-1550
(608) 643-3311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041279752
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209-003105
IL
Other
Enumeration date
02/03/2006
Last updated
05/17/2013
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