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Individual

BRIAN JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 S FILLMORE ST, OSCEOLA, IA 50213-1619
(515) 493-0195
Mailing address
1646 NW 99TH CT, CLIVE, IA 50325-6754

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D125471
IA

Other

Enumeration date
09/16/2014
Last updated
02/04/2020
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