Individual
MRS. JULIE LYNNE JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
10515 ILLINOIS RD, FORT WAYNE, IN 46814-9182
(260) 373-9200
(260) 373-9219
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28225230A
IN
363L00000X
Nurse Practitioner
Primary
71013486A
IN
Other
Enumeration date
12/02/2022
Last updated
08/30/2023
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