Individual
KAYLA MARIE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8000
Mailing address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
23535830
WI
363L00000X
Nurse Practitioner
Primary
16541
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100309907
—
WI
Enumeration date
10/19/2024
Last updated
07/13/2026
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